Inmate's suicide sheds light on extensive, but imperfect, system

June 01-- Jun. 1--From the outside, the cells of the Cheshire County jail's R-block look almost identical. But one feature on the metal doors neatly classifies the spaces -- and the inmates within them -- into two groups. Two windows: in detox or suicide risk. One window: not.

Though all of the 8-by-10-foot cells are monitored by guards, one-window doors afford some privacy. From the block's guard post, the bunk that fills much of the cell isn't visible through the single window; neither is the metal toilet.

But when the correctional facility on Route 101 (Marlboro Road) in Keene went into lockdown for a suicide attempt on Friday, May 3, guards rushed to R-111. That cell has one window.

The inmate in R-111, Michael Richmond, who'd arrived two days earlier, had seemed fine the night before, jail Superintendent Richard Van Wickler said. When a guard conducted a routine check sometime after 11 a.m. that Friday, Richmond, 44, was up and talking.

The Hinsdale resident hanged himself 15 minutes later, Van Wickler said.

Richmond was found unresponsive in his cell before noon, and jail personnel carried him to a day room, where they began CPR, according to Van Wickler. He was taken to Cheshire Medical Center and later transferred to Dartmouth-Hitchcock Medical Center in Lebanon, Keene police said. Richmond died on May 5, the state medical examiner's office said.

Though Richmond's death was the jail's first suicide in eight years, from a national standpoint it's not an anomaly.

According to a 2016 report from the U.S. Bureau of Justice Statistics, suicide is the leading cause of death in jails -- accounting for 372 fatalities in 2014 and 328 fatalities the year before. In state prisons, suicide deaths are rarer, with cancer, heart- and liver-disease-related deaths being far more common. Still, according to the bureau, there were 249 suicides in state prisons in 2014.

In the face of such sobering statistics, what can correctional facilities do to keep inmates safe?

"We train so hard and try so hard to make sure that nothing like this happens," Van Wickler said of Richmond's suicide. "And the lesson here is that nothing is a hundred percent, isn't it? You can be as prepared as you want, as trained as you want. ... Something's going to get through."

No alarm bells

Every inmate at the Cheshire County jail is screened and monitored for suicide risk, said Barnes Peterson, the mental health clinician who works there.

Richmond, he said, was no exception.

But none of Richmond's screenings -- not during his initial booking May 1, during follow-up with medical staff after his arrival, or during the regular checkups by guards trained in suicide prevention -- yielded any indication he might kill himself, Peterson said.

The jail has protocols to help inmates with mental health needs, and a sizable chunk of them receive some form of psychiatric care. The jail's annual report indicates Peterson assessed 350 people last year, one of whom was transferred to N.H. Hospital in Concord.

More than 80 percent of those inmates -- 288 -- got psychiatric medications during that period, 58 were placed on suicide watch, and 11 were assessed to be at high risk to attempt suicide.

That same year, four inmates attempted suicide. All of them survived.

Back behind bars

The circumstances that landed Richmond at the Cheshire County jail are hazy. A spokeswoman for the N.H. Department of Corrections said last month that he was arrested for a parole violation, but declined to elaborate. Richmond was put on parole after he assaulted another inmate while serving a sentence in state prison, she said at the time. It was scheduled to end in 2022.

Richmond had cycled in and out of jail, according to Van Wickler.

"He was the kind of person who lost his way with the law for a variety of reasons and was a recidivist of ours," he said. "And for the last several years, we (hadn't) seen or heard from him."

A family member of Richmond's declined, through one of his friends, to be interviewed for this story. But his obituary fills in some of the gaps: He worked at S&C Painting, a job he loved. He enjoyed fishing. He had too many friends to list.

But whatever brought Richmond back to the jail last month, he started his time like every other inmate -- in the R-block.

Inside R-block

Also known as reception, R-block is more restrictive than most units at the correctional facility; inmates there spend up to 23 hours a day in their cell for up to a week while jail staff evaluate them for communicable diseases, mental and social needs and more.

Peterson said guards check on people in the R-block often, but inmates can also talk to the guards via intercom.

During their stay in the unit, all inmates are screened multiple times for suicide risk, according to Peterson. If at any point, staff -- guards, clinicians or intake personnel -- are concerned about an inmate's safety, Peterson said, they place the person on suicide watch until he or another mental health professional can evaluate them.

"You're looking at things like, do they have hope, do they have a strong support system, do they have housing, do they have mental health treatment? ... You look at both what they actually say, and then you look at their affect, how believable is it?" Peterson added.

Jail staff err on the side of caution because the prevalence of suicide in correctional facilities is higher than in people who aren't incarcerated. According to the 2016 report by the U.S. Bureau of Justice Statistics, suicides accounted for almost a third of the 14,786 inmate deaths in jails across the country reported between 2000 and 2014.

"If anybody is any kind of indication of risk, we put them on suicide watch, and our policy is that if you're in doubt, you put them on suicide watch." Peterson said.

Male inmates with this status find themselves behind one of the unit's two-window doors. Women on suicide watch are housed in similar cells in another block, Peterson said. Other than the bolted bunk, toilet and desk, the walls of these cells have very little else, save for an intercom and a metal coat rack with collapsible hooks that buckle under the weight of anything heavier than a towel. Guards check on these inmates at irregular intervals of no longer than 15 minutes, according to Peterson.

And depending on an inmate's condition, he said, jail personnel have other tools to protect them. When inmates are actively trying to hurt themselves, staff may resort to restraining them or removing fabrics that could be used for strangulation or hanging. In those cases, Peterson noted, inmates wear a tear-resistant smock and may receive a special type of blanket.

In here and in general population, the goal, he explained, is to protect vulnerable people from what is a temporary, and sometimes fleeting, impulse to end their lives.

"People are just trying to cope with the intensity of that emotional pain in that moment, where they have hopelessness, and they feel like it's never going to get better, and this is their only solution," Peterson said. "But that arises from a distorted perception ... and so our task here is to protect people from those moments when we can."

A balancing act

Richmond never made it to suicide watch because he never raised any red flags, Peterson said. Even so, during his two-day stay, he went through at least two formalized suicide screenings -- once when he was booked, the other with a nurse. But neither flagged him as a suicide risk, according to Peterson.

"Had we seen any signs (with Richmond), we put people on suicide watch." Peterson said.

Even so, Van Wickler said, the jail's suicide prevention policies don't need to change.

"What this event has done is it has confirmed that the polices we have are very effective," he said. "It's confirmed that the (staff) training is exceptional. It's confirmed that the untested staff that we have has now been tested, and they passed the test. ... The unfortunate fact about corrections is, these things happen, and our charge is to make sure that it happens as little as possible and to do our best to preserve life as best we can."

According to Van Wickler, the jail's policies are modeled on best practices put forth by two advisory bodies: the National Commission on Correctional Health Care and the American Correctional Association. Both organizations, he said, inspect and accredit correctional facilities for a fee. The Cheshire County jail follows the best practices laid out by both, Van Wickler said, but isn't accredited by either.

"We're not required to be (accredited). ... It's an enormous cost to do," he said. "However, it should be noted that we are consistent with their recommended standards. Our policies are modeled after their recommendations. We simply don't have a representative from their agency come in here to check on it to certify us because I don't think that it's the best use of taxpayer dollars."

Among the jail's practices that adhere to these recommendations are the regular screenings and putting inmates deemed at risk in cells designed to be suicide resistant. The jail's monitoring of inmates on suicide watch at least every 15 minutes is also part of the national commission's guidelines.

Neither guide discusses strategies to prevent suicide by inmates who don't raise any concerns.

However, in its 2018 Standards for Health Services in Jail, the national commission notes that people are at greater risk for suicide between two days and two weeks following incarceration and after they are admitted into segregation or single-occupancy cells.

Peterson acknowledged this risk, but said inmates may have protective factors, such as family support on the outside, that may negate some risk factors. Determining someone's suicide risk, he added, requires an assessment of both.

Peterson said the Keene facility's days-long reception stay is necessary not only to evaluate an inmate's needs, but also to stem drug-smuggling into the facility.

Some inmates, according to Van Wickler, try to bring opioids into the jail -- particularly fentanyl -- by swallowing them. Van Wickler said the seven-day stay in R-block can ensure inmates pass any drugs before they enter general population, without necessitating a cavity search.

"I have the legal authority to cavity search every person that comes into this institution, but I will not do that," Van Wickler said. "Because for the one or two people out of a hundred that we would find something, (cavity search) is a horrible trauma for the (other) 98, and so for me, it's not worth it."

And according to Peterson, jail staff attempt to minimize inmates' time in R-block, particularly if someone shows acute distress.

There are other considerations, too. Though the tighter monitoring of those on suicide watch could prevent a death, Peterson said the process itself can be unsettling to people, particularly if they're already in emotional turmoil. Staff continually balance the harm and the good such monitoring would do, he said, but the goal is always to move people to general population as soon as possible.

"Having a camera in your cell is also intrusive," Peterson explained. "Like a lot of people feel very uncomfortable with it. A lot of people feel uncomfortable with a cell that's right in the middle of the unit and has two big windows on it. Some people will do better if they have more privacy. They feel less exposed; they feel more secure."

A 'family matter'

Almost five months before Richmond's death, a Vermont inmate who had been sentenced to more than 20 years in prison on sex crimes died in what the Vermont Department of Corrections described as an apparent suicide.

A January news release said Thomas Badger, 42, attempted suicide at Southern State Correctional Facility in Springfield, Vt., on Jan. 11. Following his death on Jan. 23, the release said, the department notified his family. His death was then announced via news release to media outlets throughout Vermont and New Hampshire.

The aftermath of Richmond's death was different.

Listed in the daily Keene police log as an ambulance call assist on Marlboro Road, the incident triggered no news release from the department, which investigated the case.

When asked about it on May 8, a Keene police sergeant described the death as stemming from an unspecified medical emergency and identifying Richmond as the man who'd died.

A week after Richmond's death, N.H. Associate Attorney General Jeffery A. Strelzin confirmed it was by suicide.

Mike Touchette, commissioner of the Vermont Department of Corrections, said his department has a standing policy to notify the public of suspected inmate suicides via written statements after immediate family is notified.

Releasing the information quells rumors, he explained, but is also about holding correctional facilities accountable.

"It's (about) being transparent and looking at opportunities to improve our own safety but not trying to hide behind a veil of secrecy either," he said.

Like the Vermont Department of Corrections, the Cheshire County jail receives a significant chunk of its budget from public funds. In 2018, roughly 64 percent of the jail's approximately $6.2 million budget came from taxes. The jail got about a third of its budget from the federal government, and the remaining 2.5 percent came from other sources.

Van Wickler -- who referred The Sentinel's initial inquiries about last month's suicide to Keene police -- said he believes the public has the right to know about these types of incidents at the jail. But he said he couldn't share information right away because the Keene Police Department was the public information agency assigned to the investigation.

Before the jail moved from Westmoreland almost a decade ago, he added, N.H. State Police investigated incidents there and allowed Van Wickler to issue statements.

Keene Police Chief Steven Russo said in an email that his department did not issue a news release about Richmond's suicide because it was a "family matter" and no crime was committed. The department, he said, doesn't issue releases in such cases, even if they occur at the jail.

"I know of nothing," he wrote, "that (says) anything that happens at a public facility should automatically be released to the public."

Liora Engel-Smith can be reached at 352-1234, extension 1439, or lsmith@keenesentinel.com. Follow her on Twitter @LEngelSmithKS.

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