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How To Avoid Preventable Deaths Among Unconvicted Jail Inmates

On October 22, Erick Tavira died by suicide in New York City's Rikers Island jail complex. He was one of at least 19 people who have died in pretrial custody this year in New York alone. Between 2008 and 2019, 4,998 people died while in pretrial detention—and this number only includes reports from the largest jails.

Despite the 2013 Death in Custody Reporting Act’s requirements, thousands of deaths have gone uncounted. These deaths often stem from systemic and harmful legal system policies that perpetuate racial and economic disparities,

To address preventable deaths of unconvicted people in custody, local law enforcement, departments of corrections, and state and local policymakers could limit pretrial detention by working toward bail reform and expediting court cases while improving mental and physical health care for people in custody, says an Urban Institute commentary by Natalie Lima and Susan Nembhard.

The pretrial population comprises 67 percent of nation's jail population. Inmates can be jailed for months or even years while legally innocent.

Sixty percent of people who have been detained pretrial in New York City for a year or more are Blacks, who make up only 24 percent of the city’s population. Similarly, making up only five percent of San Francisco’s population, Black people account for 50 percent of the people jailed for a year or longer.

Pretrial detention disproportionately harms people with mental health needs. About 17 percent of people entering pretrial detention have a serious mental illness, and 26 percent of people in jail were found to meet the criteria for serious psychological distress, compared with five percent in the general population.

In-custody deaths are most likely to occur during pretrial detention, not after conviction. More than 400,0000 people are detained before being found guilty of a crime and are the most at risk for dying while incarcerated. The leading cause of death in custody is suicide. About 77 percent of all people who died by suicide in jail have not been convicted of a crime. Other common causes include illness, drug overdoses, and violence.

The Urban Institute suggests that policymakers consider several evidence-based options to prevent pretrial deaths:

Increase pretrial diversion options and use

Research shows people accused of misdemeanors or nonviolent crimes and those who have technical probation violations may be less likely to reoffend and experience shorter sentences when they are able to return to their community while awaiting trial.

Continue bail reform efforts

Historically, bail disproportionately affects people with low incomes and people of color and is a main driver of pretrial detention. Bail criminalizes people for their socioeconomic status, not their culpability, and research suggests bail reform is a promising strategy toward change, creating more equity and reducing deaths.

Expedite court cases

When people are detained for extended periods, the chance they will experience harm increases. Implementing strategies to expedite court cases can help reduce the average length of stay for people detained before trial.

Invest in health care

Adequate health care with improved mental and physical health screenings can help prevent suicide and overdose attempts. Investing in these services can help ensure necessary medical responses are available and address illness-related deaths. Extending such services to community-based organizations can also help ensure people can access them upon release.

Increase staff training and capacity

Jail staff trained to handle crises are more capable of responding to fatal incidents and preventing deaths in custody. The majority of jail deaths occur in the first 30 days of a person’s admission. Training staff to conduct checks every day, with particular attention to people in custody who have had risks identified via validated screening, can reduce unnecessary deaths. Introducing counselors into the jail system can help reduce the trauma people experience in jail and address mental health needs before they escalate.

Kalief Browder’s story underscores this well. A 16-year-old who was sent to Rikers for allegedly stealing a backpack, Browder was unable to pay his $10,000 bail and spent three years awaiting trial. More than 400 of those days were in solitary confinement. He made many attempts to take his own life, and two years after his release, he died by suicide. Browder’s story, highlights the urgent need for change to reduce and prevent the immediate and lasting harms experienced by those held in pretrial detention, says the Urban Institute.


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