Suicide a rising concern in some Utah jails

After a three-day stint in the Utah County jail in 2010, Cory Jex told his mom he'd never be behind bars again.

"He said he'd never go back because he had so much anxiety," his mother, Michelle Jex, said. "He wasn't very fond of it."

But the next year, Cory Jex, then 22, found himself once more in the Spanish Fork facility after he violated probation when he tested positive for opiates and admitted to his probation officer that he had used heroin.

He was supposed to spend only a couple of days in the jail, Michelle Jex said. While he was gone, she went to his bedroom in their Springville home to tidy up and change the bed sheets. That way he'd have a fresh start — another new beginning — when he came home.

But on March 10, 2011, while inmates in Cory Jex's pod went to the cafeteria for a meal, he stayed behind. A jail worker later found that he had hanged himself from a shower head. He was on life support for three days before he died.

"I feel guilty," Michelle Jex said recently of her son's death. "I knew he had suicidal thoughts before, but I had no fear [about him going to jail.]"

Cory Jex is just one of the hundreds of Utah inmates in recent years that have attempted suicide while being held at county jails — and one of more than a dozen who completed the act.

Records show that suicides and suicide attempts are rising in some Utah jails, but officials question whether the increase is merely a reflection of the upward trend that is occurring in society in general. They say they are doing all they can to prevent harm coming to those under their care — a population that tends to be highly unstable, susceptible to depression and are placed in a new environment that can be cramped, noisy and frightening.

—

Societal problem • Weber County Undersheriff Kevin McLeod does not dispute that suicide numbers are high at the Weber County jail — more than twice as high as neighboring Davis County, which had four people commit suicide at the jail compared to nine at Weber County since 2009. McLeod believes, however, that high suicide numbers in jails reflect the climbing number of suicides in society at large.

"I've been in this business for over 35 years. I've never seen in-custody suicides as high as they are today," McLeod said. "But I've never seen attempted or threatened suicides and completed suicides in the public as high."

McLeod said when he initially started his law-enforcement career, deputies responding to suicide threats or attempts were rare. In recent years, that has shifted dramatically.

"We go on them daily," McLeod said.

According to the Utah Department of Health, the number of Utahns who kill themselves has been increasing for years. In 2009, 459 Utahns killed themselves, and 478 committed suicide in 2010. In 2011, 524 took their own lives, while 563 did so in 2012.

—

'De facto mental institutions' •McLeod said a large number of inmates in the Weber County jail have a common denominator driving their criminal behavior: drug addiction. Certain inmates become masters of instability: They are on drugs, come into the jail and get stabilized on antidepressants and then are released and continue their drug habits and ditch the medication.

"We take the highest-risk individuals there are and put them in our jails," he said. "The unfortunate part of our society is that mental health is underfunded. Jails end up being de facto mental institutions."

Salt Lake County Sheriff Jim Winder said in a recent interview that many of the inmates who wind up in the Salt Lake County jail commit crimes because of their underlying problems with mental illness.

"It's not because they are evil; it's because they are mentally ill," Winder said. "Knowing the difference in that is not easy."

And knowing how to interact with an inmate who has mental health issues is not a simple task for medical staff or deputies.

Joel Allred, a licensed clinical social worker with Davis Behavioral Health, is one of two therapists available to inmates at the Davis County jail. He said in a recent interview that inmates who are psychotic are some of the most difficult to treat and contain in a jail setting. They can't be housed with another person because of safety issues, he said, and there are limits to how long they can be kept on suicide watch in a safety cell.

"People that suffer from psychosis are a little more worrisome to me," Allred said, "because they are more unpredictable."

—

Methods •With obvious items removed from cells that would assist in suicide, some inmates go to extremes to try to end their lives. For instance, some fling their bodies over the second-tier railings in their housing pods at the Salt Lake and Davis County jails.

But according to a Salt Lake Tribune analysis of records from five county jails in Utah, inmates most often attempt to end their lives by asphyxiation — hanging or strangling themselves with everything from bed sheets to clothing to towels. The second-most frequent method was cutting, though instances of inmates trying to electrocute themselves, drinking cleaners or banging their heads against the cell walls also were recorded.

In the Weber County jail, nine inmates have committed suicide since 2009, four in 2013 alone, according to data from the Weber County Sheriff's Office. All of the inmates died as a result of hangings. Most of the inmates were booked into the jail on suspicion of drug offenses, probation violations or minor crimes such as failure to appear in court and retail theft. But two of the deceased inmates — Jeffrey Dean White and Matthew David Stewart — were accused of homicide.

White, who was accused of beating his live-in girlfriend to death, hanged himself in the jail Nov. 14, 2012. On May 24, 2013, Stewart was found hanging from his bed sheet after being housed in the jail for more than a year while awaiting trial for aggravated murder and other charges related to a shootout that erupted at his Ogden home in 2012 that ended with one police officer being killed and five others wounded.

McLeod said hanging deaths are most often fatal inside jail walls because it takes only a few minutes for an inmate to perish, and oftentimes, jail workers can't check on every inmate that frequently.

"We just don't catch them soon enough," McLeod said.

In the Davis County jail, four instances of inmates hanging themselves were recorded in a six-month span this year, with two inmates dying at the jail and another two who expired in the hospital, outside of jail care. Since 2009, the jail has had 73 suicide attempts, according to data from the Davis County Sheriff's Office.

The Salt Lake County jail has not had an inmate complete a suicide attempt inside the jail since August 2011, when Steven Edward Elliott — who was arrested on suspicion of burglary, theft and possession of stolen property — cut himself with a blade taken from a jail-issued razor. Details about how the cuts became fatal for the man were blacked out of records requested by The Salt Lake Tribune. The last suicide before that was in August 2009, when Nicole Dubarry tied a bed sheet around her neck and a railing, and hanged herself by jumping off the second tier. She had been held at the jail on suspicion of robbing several pharmacies.

Winder said his deputies have intervened in 381 suicide attempts since 2009 at the county jail, with only two completed suicides.

"I think we are doing a hell of a job of suicide prevention," Winder said.

But Winder said inmates who attempt suicide and later perish while in a hospital's care are not counted as "in-custody" deaths, and they are not reflected as a completed suicide in their statistics. Both Weber and Davis counties provided data for inmates who died at the jail and in hospital care after a suicide attempt.

Since 2009, Utah County has had two jail suicides, one in August 2010 and Cory Jex's suicide in 2011. They had 45 instances classified as "attempted suicides," mostly concerning inmates attempting to cut or hang themselves.

In Washington County, no inmates have committed suicide within the jail since 2009, but two inmates who hanged themselves later died in hospital care, according to county jail officials.

—

Prevention •Screening processes to determine whether an inmate is suicidal and needs specialized treatment or should be housed in a more secure cell are similar across counties in Utah. Generally, inmates are screened when they come in and are asked if they are suicidal or have had thoughts of harming themselves. McLeod said that inmates oftentimes will immediately be put into secure cells based on their alleged crimes, such as someone who is accused of killing a family member and may be emotionally unstable.

Inmates often feel vulnerable, threatened or abandoned in a jail setting, according to Allred. Mixing these emotions with previous mental health issues or drug-addiction withdrawals can create a tumultuous jail experience, causing greater concern for self-harm. Allred said therapists try to get a handle on inmates' mental health issues when they come through the door, asking questions about their mental health history and whether they've had previous thoughts of suicide.

"It's tough," he said. "We try to do a better job at the door, and put some questions into the intake form. [We]question them about mental health treatment, if they have been on medication."

If inmates are put into a general population housing unit, they can be moved into suicide watch based on their interactions with deputies, other inmates or with mental health workers. And if family members call the jail with concerns that they believe an inmate may want to harm themselves, their requests also are given special attention.

Michelle Jex said she never called the jail to report that her son had a history of depression, but a lawsuit she later filed against Utah County authorities in U.S. District Court alleges that though his probation officer knew of his history of anxiety, depression and multiple suicide attempts, the probation officer listed in an assessment form that he was "upbeat" and wasn't under the influence of any drugs.

"I don't feel like they assessed him right," Michelle Jex said.

Michelle Jex said she filed the lawsuit — which was dismissed by mutual agreement of both parties in August — hoping that it would bring changes in the way depressed or suicidal inmates are screened and monitored in jail.

"It's supposed to be a safe place down there," she said of the Utah County jail. "But they didn't keep my boy safe."

—

Deputies are affected, too •Winder said suicide prevention is one of the top responsibilities for officers dealing with inmates. First, the officers must ensure their own safety, and second, ensure the safety of the inmates. Their third responsibility is to make sure inmates don't harm themselves.

That job can be difficult for the officers, according to Salt Lake County Deputy Chief Pamela Lofgreen, because staff members often are attempting to intervene in "gruesome scenes," and when an inmate doesn't survive, it takes its toll on the staffers.

But deputies are given crisis training so they are able to respond quickly and properly to inmates who are trying to harm themselves.

"There is a certain amount of shock the body gets," Davis County Sheriff Todd Richardson said, referring to when deputies come upon inmates trying to kill themselves in the jail. "It's traumatizing for them."

Richardson said they offer an employee-assistance program to help jail workers.

McLeod said Weber County jail workers care about the inmates and oftentimes go through their own counseling to help them deal with the suicide of an inmate.

"That's how bad it bothers them," McLeod said. "We don't want it to happen."

—

Can it be changed? •It's difficult to balance inmates' rights to have the most basic of items, such as razors, clothing and blankets, with the risk that some inmates will use them to harm themselves.

They are damned if they do, damned if they don't, McLeod said: Give inmates a blanket, and complaints flood in if they hurt themselves with it. Refuse inmates a blanket, and jail workers are accused of being inhumane.

"We think about it all the time," McLeod said. "We just don't know what the answer is. … To try and pin down, and eliminate every opportunity and tool, that method is impossible. If they are predisposed, convinced [to kill themselves], we can't stop it. We can't watch them 24/7. … I have absolutely no question at all, we are doing the best we can."

Both Richardson and Winder said their staffs come together after an attempted suicide to discuss the incident and what can be done to prevent it in the future.

"We take a step back," Richardson said, "and look at safety and security."

Michelle Jex said she hopes things are changing inside the walls of Utah's jails, but she's not sure anything has. She said she no longer has contact with anyone at the Utah County jail, and she won't even drive anymore by the Spanish Fork facility, which is just a few minutes from her home.

"It's hard for me," she said, her eyes brimming with tears. "I struggle with it every day and night, 24/7. It's just isolated me. I will never be the same person, ever. It's changed my life forever."

jmiller@sltrib.com

Twitter: @jm_miller