Little more is known about Mustafa Qverterman than when he died, and where–in a cell at the Contagious Disease Unit in the West Facility on Rikers Island on Christmas Day, 1998–and that he killed himself by standing his bed on end and hanging himself from its edge.
The Board of Correction, an independent agency that oversees the massive New York City Department of Correction jail system, is reviewing Qverterman’s suicide, along with seven others that occurred between July 1998 and June 1999. It’s a noticeable uptick: In fiscal years 1997 and 1998 there were five suicides in city jails. In 1996, there were only three. The increase comes despite dramatic decreases in violence at the jails–down 55 percent in just the last year–and an almost 7 percent decline in the daily jail population over the past five years.
Every suicide in the city’s jail system is investigated by the Board and Department of Correction. (“One is too many for us,” says DOC spokesperson Thomas Antenen.) But now the Board is taking an especially close look to see why there might be an increase in inmates taking their own lives. Says Board Deputy Director Kathy Potler, “We’re looking at any trends–any issues that would come up. It’s something we’ve wanted to do for a while.”
Several issues are ripe for the probe. With greater rates of mental illness and suicide than state and federal prisons, city jails also now host large numbers of inmates detained for quality-of-life crimes–people who never contemplated the possibility of jail time are ending up behind bars for crimes like public urination or possession of alcohol.
At the same time, the Department of Correction has adopted a hard-nosed anti-violence strategy at the jails. While it has reduced the number of incidents tremendously, the effort relies on invasive measures such as regular cell searches, which were up 38 percent last year alone.
Then there are the usual questions of whether the staff or the structure of the prisons may contribute to the problem. A May suicide reportedly resulted in several suspensions and transfers of DOC staff, although Antenen insists the moves had to do with other management problems. And the structure of the cells themselves may have helped inmates hide from guards long enough to take their lives in at least three cases over the past two years.
But the jails’ health and mental health care, already under fire, is also under the microscope. Ever since the Department of Correction and the city’s Health and Hospitals Corporation hired private St. Barnabas Hospital to run health services for Rikers and some of the other jails in January 1998, replacing Montefiore Medical Center, critics have charged that the hospital has cut corners on care. The Manhattan District Attorney and State Attorney General investigated these health services last year. Two groups of prisoners are suing St. Barnabas and the city for allegedly subpar health care. And at a Board of Correction meeting last year, officials reported that medical complaints–such as allegations that health providers weren’t paying attention to sick inmates–have quadrupled since 1996.
New York City’s jail system–consisting of 10 facilities on Rikers and four other jails–locked up 130,000 inmates last year. Rikers hosts 16,000 on any given day. The jails’ mostly transient inmates may be awaiting trial, biding time until a transfer to a state prison, or serving a brief sentence. Three-fourths to 95 percent of the jail population is addicted to alcohol or drugs.
After 11 inmates killed themselves in city jails in 1985, the city implemented a set of minimum standards for mental heath care. Suicides fell dramatically, and in fiscal 1993, there was only one. Antenen calls the standards a “comprehensive plan” that is “regularly looked at as a model in the country.”
Today, roughly 25 percent of inmates get mental health care in the city’s jails. Many mentally ill inmates can stay in the general prison population while they receive psychotropic drugs and counseling. Some of the more seriously mentally ill are housed in Mental Observation Units or Rikers’ 24-hour, seven-day-a-week Mental Health Care Center, which offer medication, individual and group therapy and extensive suicide prevention measures. Unusually aggressive mentally ill inmates go to the 24-bed Behavioral Management Unit in the Bronx, run by St. Barnabas, and extremely disturbed inmates are taken to one of the prison wards at Elmhurst, Bellevue or Kings County hospitals.
In order to use those services, inmates must first be diagnosed with some mental problem. Medical staff are supposed to see the inmates during the first 24 hours of confinement and are allowed up to four hours to test for physical and mental illness. This intake screening is crucial; corrections experts say it’s the initial shock of imprisonment that often triggers a suicide attempt.
But the city’s correctional facilities often don’t receive inmates until they’ve spent several hours incarcerated in a precinct lockup or courthouse holding pen. In addition, 20 percent of DOC inmates are in and out of jail within 72 hours, and 50 percent within a week. The head of the city’s correctional health services has admitted that not everyone can be seen by a mental health staffer by the time they leave–and indeed, the Board of Correction has received whistleblower reports that medical staff is too small to handle the inflow of inmates. Correction officers union president Norman Seabroook says his guards echo those complaints: “I get a sense that there are more back-ups now,” he says.
Responds HHC spokesperson Jane Zimmerman, “There was a restructuring of staff, as with any new affiliate. Staffing needs are assessed on a regular basis.” A 1998 HHC report states that jail health care staff is the same size as it was when Montefiore handled the contract. But critics of the St. Barnabas arrangement say that the way its $340 million, three-year contract is structured allows the hospital to scrimp on care, because a portion of any money that the hospital doesn’t use for care it can keep. “In general,” says Urban Justice Center lawyer Heather Barr, an attorney for one of the groups of inmates suing the city, “the structure in the contract has created an incentive to provide lousy services.”
HHC officials deny the contract is flawed, and they point to a set of 35 performance indicators that are supposed to be reviewed quarterly. But Ernesto Marrero, director of Correctional Health Services, could not say exactly how well St. Barnabas is performing on those indicators because he is currently reviewing nine months’ worth of data. Zimmerman says that her impression is “overall, St. Barnabas has been meeting medically acceptable standards.”
Other evidence, however, suggests that St. Barnabas still has work to do. At a July 1999 Board of Correction meeting, members found that “medical staff has been under-reporting attempted suicides,” and called for HHC to develop a new reporting procedure. At another meeting, board members expressed concern that St. Barnabas was using pills in cases where liquid medications, while more expensive, would guarantee that inmates could not stockpile drugs for suicide attempts. (All “dangerous drugs,” says Marrero, are already dispensed in liquid form.)
Gerald McKelvey, a spokesperson for St. Barnabas, says the hospital provides “customary and ordinary mental health services to the extent that it can be rendered in the setting on Rikers Island.”
Antenen insists that the DOC takes the problem of suicide very seriously; indeed, reducing the number of suicides is the second of five performance goals for Correctional Health Services. DOC recently assigned suicide prevention aides–inmates trained to observe other inmates–to all three shifts at a Rikers infirmary. And Antenen said in an early December interview that staff at the prisons was on extra alert for suicides as the holiday season began.
Even as the Board’s probe proceeds, guards at Rikers Island patrol the tiers of cells carrying an instrument called a 911 (“nine-eleven”) knife. It’s a specially curved blade that can’t be used as a weapon. Its only purpose is to cut down an inmate who’s hanged himself. Guards in city jails have carried the knives for over 10 years.
The knives are metallic proof that depression, fear and suicide are facts of life in jails. “People killing themselves in jails and in prisons is nothing new,” says Maddy deLone of the Prisoners Rights project at the Legal Aid Society. That suicides occur is no scandal; the question is whether New York City’s jails are doing all that they can to prevent inmates from taking their own lives. Says deLone: “It’s not just that stuff happens–people just let it happen at some level.”