Date of Award

Spring 5-11-2024

Document Type

Dissertation

Degree Name

Doctor of Philosophy in Clinical Psychology (PhD)

Department

Clinical Psychology

First Advisor/Committee Member

Keyne C. Law, Ph.D.

Second Advisor/Committee Member

Lynette H. Bikos, Ph.D., ABPP

Third Advisor/Committee Member

Jorge Lumbreras, Ph.D.

Abstract

Across jails nationwide, suicide remains the leading cause of death. Suicide has been the leading cause of death for U.S. jail inmates for over 40 years. In Washington State, suicide accounts for 47% of all jail fatalities while incarcerated. To address this critical issue, the U.S. Justice Department set best practices for jails to follow for suicide prevention programs in 1989. Yet, these best practices have not reduced the disproportionate rate of jail suicides. Far from a decrease, suicide deaths for jail inmates rose 13% in the last 20 years. This dissertation involved three methods of analysis for this critical issue. First, a thematic analysis was conducted on all suicide jail death records in Washington State from 2004 to 2021. Second, a dataset of 29 Washington State jails’ suicide prevention and training policies was evaluated. These policies were scored according to their adherence to the best practices for jail suicide prevention. Scores were correlated with jail-specific suicide rates (in deaths per 100,000 residents) to determine whether best practice adherence was associated with disproportionately low suicide rates. Finally, a narrative analysis was conducted on project-wide themes. Results suggested that though many factors in best practices were associated with individual jail suicides, best practice adherence was not actually associated with jails’ suicide rate on a systemic level. Implications from these results include problems with implementing on-the-books policy by correctional staff, and the possibility that current best practices, nearly 35 years old, may no longer be the most effective components of jail suicide prevention.

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