The truth about suicide behind bars is knowable

The truth about suicide behind bars is knowable
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Jeffrey Epstein’s suicide in a protective housing unit of the federal jail in Lower Manhattan has prompted a flurry of dismay and outrage over a jail-attributable death.

The reality for millions of Americans is that conditions behind bars involve routine physical and sexual abuse and medical neglect. Often, reporting the truth about this abuse results in swift retaliation against victims and disbelief by the general public.

As we consider how to undo America’s misadventure in mass incarceration, we must address these horrific conditions. We can start by independently monitoring all jails, prisons and immigration detention centers.


When news broke of Epstein’s suicide, questions were immediately raised about whether he was being monitored for suicide risk, with two federal probes launched immediately.

We can be certain about one thing: Whatever systematic failures contributed to his death have played out many times before, harming countless other people, most of whom were not wealthy white men.

Suicide is the leading cause of death in American jails. Almost 5,000 people die every year from all causes while incarcerated. Suicide in jail often reflects a lack of basic suicide prevention measures as well as practices that increase the likelihood of mental anguish and self-harm, including solitary confinement and forced withdrawal from opiate use.

One of us (Five) spent more than five years languishing in solitary confinement in both county jails and New York State prison. There, beatings by security staff and neglect by medical staff were routine, and the lack of consequences for abuse was fueled by the absence of outside experts to learn and report on the truth of conditions. The other of us (Homer) has also investigated numerous suicides in jail that revealed a toxic blend of health staff who don’t believe or advocate for their patients and poorly trained or staffed correctional officers

If we are going to respond to this incident ethically and honestly, we should commit to developing a network of independent experts (people who have been incarcerated as well as health and security experts) who can freely monitor detention conditions.

This type of “golden key” monitoring of detention facilities is routine in Europe and scores of other nations that have enacted the protocols of the United Nations Convention against Torture. Some states, like California, Illinois and New York, have developed limited pathways for this type of monitoring, but with little data sharing or a standardized approach. By comparison, we have standardized approaches to the inspection of hospitals, outpatient clinics and even food processing plants and coffee shops.

On social media, a recently trending hashtag encourages politicians to visit a prison or jail. The ability of these visits to instill empathy is clear. But we need to organize teams of independent monitors, give them standards by which they can inspect and report on conditions of confinement and ensure that every detention facility in the U.S. has at least one inspection report per year.

Some of the critical elements of these inspections include seeing all the physical spaces in each facility, speaking with staff and detained people and evaluating the quality of health services with data on suicide prevention, jail-attributable deaths, injuries, sexual abuse, staffing and training.

This approach to independent monitoring should be led by the Department of Health and Human Services and Department of Justice (where the highest quality inspections currently occur via individual investigations). But we need not wait. Every state governor should be pushed to support independent monitoring with a set of national standards in their state prison systems. And every state legislature should enact mandates for independent monitoring in county jails, state prisons and immigration detention facilities.

At the city and county level, local governments should be pushed to do the same, with the mandate of standardized, independent and public reporting. These are issues political candidates should be asked about.


There are costs to implementing independent monitoring of detention spaces, no doubt. But a high-profile incident like the suicide of Jeffrey Epstein reveals the hypocrisy of mass incarceration and the brutality of our correctional system. The approximately 12 million incarcerations that occur each year are disproportionately people of color, people with behavioral health problems and, increasingly, women.

Our zeal to understand the jail-attributable death of a wealthy white man will be revealed as pretense unless we commit to a system of independent monitoring that covers every place of detention in the U.S.

Five Omar Mualimm-Ak is president and CEO of Incarcerated Nation Corp. Homer Venters is the former chief medical officer of the New York City jail system and author of “Life and Death in Rikers Island.”