Preventable In Custody Fatalities

Preventable In Custody Fatalities

The housing of people within a detention center is one of, if not the most high liability tasks performed by the Washoe County Sheriff’s Office.  We are tasked with two things, the Care and Custody of inmates.  Custody is by far the easiest of the two as long as no one is leaving without permission.  Care is far more complex and if done incorrectly, can result in an increase in In-custody deaths and law suits.  While some deaths are inevitable, preventable deaths are where our focus must be.  After all, these are your sons, daughters, fathers, mothers and neighbors and incarceration at a county jail, must never be a death sentence.

To significantly impact preventable in-custody deaths, the issue must be broken down into several categories, appropriate, comprehensive medical assessment and care, identifying potentially high risk populations and behaviors and training staff to respond to medical and mental health situations quickly and effectively.  Even one preventable death is too many! 

The contracted medical provider must have a clear understanding of mental health disorders as well as alcohol and drug related medical issues, accompanied by solid procedures to deal with these conditions.  Upwards of 80% of the inmate population has drug, alcohol or mental health diagnosis with many having  co-occurring disorders.

Deputies must be provided and trained on a comprehensive suicide prevention plan.  This plan must identify high risk populations such as LGBTI who have a suicidal ideation rate of 67% and a suicide attempt rate of 38%.  Several of the recent in-custody deaths at Washoe County were attributed to Excited Delirium.  This is a condition where drugs consumed, interact with a persons brain chemistry usually following a struggle, which causes life threatening heat, brain and heart issues, ending in the sudden death of the person.  Comprehensive training on this topic has been available for many years but not taken advantage of at all until very recently and then in an on-line format which is less than effective.

Deputies must be trained and allowed to supervise the jail population in a manner that allows them to be keenly aware of what is happening in a particular inmates life that may lead to an in-custody death so they may intervene.

As a community we must “Forge a New Path” within our Law Enforcement agencies and not rely on what brought us to our current state of affairs.