T.R., P.R., K.W., et al. v. South Carolina Department of Corrections: A Public Health Policy Proposal for Suicide Prevention within the South Carolina Department of Corrections. Open Access

Thornley, Nicola Ellen (2016)

Permanent URL: https://etd.library.emory.edu/concern/etds/mg74qm88b?locale=en


Suicide is one of the leading causes of death in South Carolina Department of Correction facilities. In 2005, a court case was filed for unconstitutional treatment of severely mentally ill inmates within the South Carolina Department of Corrections. In 2014, the inmates were found to have endured mistreatment including the following: use of force; duration in isolation; pepper spray; cleanliness and temperature of segregation cells; and, administration of psychotropic medication. The Court found a multitude of suicides, occurring mainly in isolation, to have been preventable had the inmate received proper and immediate healthcare and/or been under constant observation. The Court also found the medical records to be insufficient and requested a new system be implemented. Six factors were deemed in need of correction in the 45-page ruling. The six factors were:1) screening and evaluating for mental illness at intake; 2) a mental health treatment program; 3) a sufficient increase in number of mental health workers; 4) mental health records that are accurate, complete and confidential; 5) supervised and evaluated administration of psychotropic medicines; and, 6) a suicide prevention program. The goal of this thesis was to come up with effective solutions for each of these factors, with a focus on a comprehensive suicide prevention program.

Methods: This thesis utilized the eight-fold pathway as the public health methodology to come up with a solution to the systemic and unconstitutional treatment of mentally ill inmates within the SCDC.

Results: We found a two-fold solution is needed that 1) addresses the need for a Mental Health Review Board to provide oversight and governance over a mental health treatment program; and, 2) created a suicide prevention program to eliminate the preventable deaths that occur yearly in the SCDC.

Conclusion: The eight-fold pathway provides an effective method that shows a way for systems to be created and implemented that can successfully mitigate seriously mentally ill inmate's suicide attempts and deaths due to suicides. The public health community can work to educate and inform the general population so that a significant reduction in the prejudice that surrounds mental illness and suicide occurs.

Table of Contents

Introduction 1

Problem Statement 1

Purpose Statement 4

Research Questions 4

Significance Statement 5

Definitions of Terms 6

Literature Review 8

Introduction 8

Body of Literature Review 9

Conclusion 25

Methods 26

Introduction 26

Analytic Plan 26

Findings 35

Introduction 35

Key Findings 37

Conclusion 60

Discussion 62

Introduction 62

Summary of the Study 62

Limitations 63

Implications for Public Health 64

Future Directions 64

Conclusion 66

References 67

Appendix A: Institutions

Appendix B: SCDC Organizational Chart

Appendix C: MINI

Appendix D: Suicide Assessment Survey

Appendix E: Court Case

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