Eleven South Carolina prisoners committed suicide last year. The number is almost double what it was in 2017.
It is a grim all-time record for corrections officials who say they're doing what they can to address the mental health needs of its inmates. It comes just a few years after leaders vowed to do more to respond to mental health issues in prison. More resources would help mitigate the problem, the director said.
Three people incarcerated in state prison have killed themselves so far this year.
The spike in 2018 follows a trend of an increasing suicide rate across the country that has puzzled and worried health experts. The rate of suicide in South Carolina's general population increased by 34 percent over a 10-year period, according to data from the S.C. Department of Health and Environmental Control.
Rates of suicide in SC prisons
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Suicides in South Carolina's prisons happened more than three times as often in 2018 as they did in the general population, on a per capita basis.
Much more attention has been paid to other kinds of violence and causes of death in South Carolina's prisons after a riot last year left seven inmates dead.
While the numbers of prison suicides is small, the rising rate is a concern.
Corrections Director Bryan Stirling said about 25 percent of the state's inmates are mental health patients, and the number of people who need treatment is growing.
He called the Department of Corrections the "largest mental health provider in the state."
With the pressure on to treat the mental health concerns of people in the prison system, Stirling said the department has tried to hire more people who can offer mental health treatment.
To make care more accessible to inmates, the prison system also began bringing providers in virtually, through telehealth. Prisoners can talk with clinicians over video. The strategy is fast and reduces the cost of transporting prisoners outside the gates for care.
Several psychiatrists and psychologists at the Medical University of South Carolina are also studying the factors that led prisoners to kill themselves in the last three years. They will present a report with recommendations to the prison agency.
"We’re hoping to find systematic changes to prevent suicides in the future," Stirling said.
Lawsuit helped bring changes
The uptick in suicides comes about three years after the Department of Corrections agreed to settle a class-action lawsuit after 11 years of litigation. The group Protection and Advocacy for People with Disabilities brought the suit in 2005 after finding instances of abuse and neglect of mentally ill prisoners. A judge ruled in the group's favor in 2014.
“The evidence in this case has proved that inmates have died in the South Carolina Department of Corrections for lack of basic mental health care, and hundreds more remain substantially at risk for serious injury, mental decompensation and profound, permanent mental illness,” Circuit Judge Michael Baxley wrote then.
Bill Lindsey, executive director of the South Carolina chapter of the National Alliance on Mental Illness, said the system has made improvements since the class-action lawsuit. The number of clinicians on hand to help is a problem, Lindsey said. Stirling said the Department of Corrections has about 14 psychiatrists on staff.
NAMI provides training to prison officers on how to deal with mental illness. Lindsey said it can be hard to tell from the outside how carefully its guidelines are followed.
As is the case in the outside world, suicides happen for many reasons. But Lindsey said the conditions in prison can make it harder to cope with a psychiatric illness or hard circumstances.
"You’re isolated, and you have a lack of hope," Lindsey said.
Forensic experts with MUSC are mining and analyzing thousands of pages of data about recent suicides in the prisons, said Dr. Diana Mullis, director for the community and public safety psychiatry division.
The team will develop a template that will help the corrections department identify those at a high risk for self-harm. A final report will help the department make needed improvements, Mullis said.
"They're being very proactive," she said.
A grim rate
All three inmates suspected of committing suicide in prison this year were found in their cells.
Richard Mayfield was found Feb. 11 at the McCormick Correctional Institution. A coroner ruled his death a suicide.
Steven Abbott was found at the Kirkland Correctional Institution. He was in his early 30s and already had served several years of a 20-year sentence for armed robbery.
Two days later, Desiree Almgren was found unresponsive in her cell at Camille Griffin Graham Correctional Institution in Columbia.
Almgren was sentenced to 30 years in prison in 2016 following the death of her boyfriend's 2-year-old son, The State reported. She was charged with voluntary manslaughter. Almgren was 20 when she was sentenced.
Almgren made poor choices and trusted the wrong people, according to her obituary.
"She learned through that process that all that mattered is what God thought of her and she began to heal," the obituary said. "She continued to struggle, but now she is free."
South Carolina's rate of prison suicide rivals other states reporting record-high numbers.
North Carolina had a record-high number of suicides in prison last year, with 12 recorded, the Charlotte Observer reported. Considering South Carolina's smaller prison population, the rate in the Palmetto State was considerably higher.
South Carolina's rate was double Texas' in 2018, when that prison system hit a 20-year high number of suicides, the Houston Chronicle reported.
Men in prison are at three times more likely to commit suicide than their peers in the general population, according to a 2017 study published in The Lancet Psychiatry. Women are at a nine times more at risk.
It is hard to pinpoint why the overall rate of suicide is climbing, said Alexandra Karydi, director of the Office of Suicide Prevention at the S.C. Department of Mental Health.
The reasons why people kill themselves vary depending on their age, community and many other reasons, she said.
Karydi said she has trained correctional officers on how to screen inmates for suicide risk.
People are much more open to discussing how to prevent suicide today than they were in years past, Karydi said. That goes for the prison system, too.
"I don’t think it’s for a lack of trying," Karydi said. "There are so many pieces to address."