Within minutes on the first Sunday of October, one inmate at the Ash Street Jail was found dead in his cell, an “apparent” suicide, and another tried to take her life. The Bristol County sheriff has again been called to answer, as he has many times before, for deaths of despair on his watch.
If Adam Howe’s suicide on Oct. 2 is confirmed by the state medical examiner, it would be the 22nd suicide of a person in Bristol County custody since 2006 that appears in the sheriff’s department records. All of these people were waiting for court proceedings, not serving sentences, the sheriff’s department said.
The woman who attempted suicide the same day was also not serving a sentence, arrested the day before for violating a restraining order, according to reporting by The Public’s Radio in Providence.
A count of suicides using records other than the sheriff’s own would also include one person in 2016 whose death by suicide at the Jail and House of Correction in North Dartmouth is confirmed by the Massachusetts Department of Public Health, and in published statements by the man’s sister. His suicide, which according to a published report also occurred in pre-trial detention, brings the toll to 23.
By any of these accounts, Bristol County’s suicide toll would be the highest for any Massachusetts county since 2006.
The next highest county totals are Suffolk and Essex, where there were 15 suicides in each jurisdiction in that period. Each of those counties accommodate hundreds more people in custody any given day than Bristol County, where the Ash Street Jail and the Jail and House of Correction complex in North Dartmouth can house as many as 1,468 inmates and pre-trial detainees, according to sheriff’s office records. The average daily population in Bristol County institutions ranges between 600 and 800 people.
Well before Howe’s death, the suicide toll had already emerged as a point of argument in the 2022 campaign for Bristol County Sheriff, pitting the incumbent Republican Thomas M. Hodgson, who is seeking a fifth six-year term in office, and his Democratic opponent, Attleboro Mayor Paul Heroux.
Heroux, who boasts a graduate degree in criminology and four years of experience working in prison systems in Philadelphia and Massachusetts, points to the numbers and argues that the Bristol County Sheriff’s Office is failing in a fundamental job: keeping people in custody safe.
Lawsuits filed against the sheriff by at least two women whose sons committed suicide in Bristol County custody claim officers failed to pay attention to obvious signs that their loved ones were in trouble.
A sheriff’s office in-house review of department practices surrounding suicides that was issued in 2018 found that the staff followed proper procedures in every case. Hodgson in his public statements on this subject pays due respect to the human loss, but he defends his staff and deflects the critique of his agency in two ways.
He often says that suicide is the leading cause of death in U.S. jails. Strictly speaking, this is true only if you compare suicide to any given individual illness, such as cancer, heart or respiratory disease, but not if you count all illness as one natural cause of death. In 2000-2019, according to the U.S. Bureau of Justice Statistics figures on local jails — meaning institutions holding pre-trial detainees and people serving sentences — 10,261 inmates died of illness, about half of total deaths, while 6,217 died by suicide.
Hodgson also links the high suicide number to substance abuse in Bristol County at large.
Substance abuse is indeed a significant problem in Bristol County, and drug or alcohol misuse is considered by experts in the field a risk factor for jail and prison inmate suicide. The numbers, however, do not suggest that drug abuse in the community correlates with jail suicides.
In Bristol County, according to the Massachusetts Department of Public Health, 2,170 people died of drug overdoses between 2010 and 2021. During the same period, 3,140 people died of drug overdoses in Middlesex County, 2,425 in Essex. Those counties lead the state in the number of drug overdoses, but not inmate suicides. Inmate suicides for that period numbered six in Middlesex, 15 in Essex.
In short, in his public remarks, Hodgson does not allow that relatively high inmate suicides reveal a problem in his agency. His spokesman, Jonathan Darling, affirmed that view.
“I would agree with the sheriff, suicide is not a problem” particular to Bristol County jails, Darling said. “Nowhere in the world is suicide-proof. We do the best we can to prevent them … We offer a plethora of mental health services. The sad truth is if someone wants to kill themselves, it’s very difficult to stop them.”
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Suicide among people behind bars is certainly significantly higher than in the general population, particularly for inmates in pre-trial detention.
Hayden P. Smith, a criminologist at the University of South Carolina who has published extensively on inmate self-harm and suicide, said that the most current information from the National Institute of Justice, a part of the U.S. Justice Department, shows that suicides in jails in the United States occur at twice the rate of the population at large. He said that if you also include a range of suicidal behavior, including suicidal thoughts and attempts, international samples show the frequency may be six to seven-and-a-half times higher in jail inmates than in the general population.
The suicide rate per 100,000 people is also significantly higher in local jails — which accommodate pre-trial detainees — than in state and in federal prisons, according to the Bureau of Justice Statistics, also a part of the U.S. Department of Justice.
Smith said significant risk factors for suicide in jail are not so different from suicide risk factors identified by the U.S. Centers for Disease Control for the general population, including a previous suicide attempt, history of depression and/or other mental condition like substance abuse.
An analysis of prison suicide risk factors based on nearly 80 studies encompassing 35,000 inmates published last year in the medical journal The Lancet included those risks counted by the CDC, and added two factors that are particular to jails and prisons: inmates housed alone without cellmates, and absence of visits from family and friends.
Smith and Dr. A. E. Daniel, a correctional psychiatrist and expert on suicide in jails and prisons, add to this a number of other factors that could contribute to suicide risk, including access to phones, procedures for admitting new inmates to identify suicidal people, programs for inmate education and psychological counseling, sufficient numbers of correctional officers and training officers to spot and properly handle people who may be suicide risks.
Both Smith and Daniel agree on a broad point: much is known about inmate suicide, and much can be done. The subject, said Smith, has been studied for decades. Darling’s comments notwithstanding, Smith said “in most cases, suicide is predictable and preventable.”
What is known in Bristol County is that all of the suicide victims who appear in sheriff’s office records had been charged with some offense, but were not serving sentences, Darling said. All were awaiting legal proceedings, and two had not yet appeared for an arraignment. Howe, a 34-year-old who was arrested in Truro on the last night of September and charged with killing his mother, would be a third suicide victim who had not appeared in court.
Soon after Howe’s death, Hodgson said his staff did everything right, considering the precautions that were taken to keep Howe from hurting himself.
A 34-year-old father of a 2-year-old girl, Howe had a history of mental health struggles dating back to 2020, according to the Boston Globe. After he was arrested on Friday Sept. 30, he was cleared to be sent to Ash Street by a judge in consultation with a doctor at Cape Cod Hospital and the prosecutor. Still, Hodgson said his officers took the extra step of putting Howe in a smock designed to impede a suicidal person from harming themselves, and having an officer check on him every 15 minutes.
“They should be applauding us,” Hodgson said on WBSM Radio on Oct. 5.
This pattern of suicides among people awaiting legal proceedings is consistent with the broad understanding that local jail inmates are at greatest risk of suicide in their first days, or even hours behind bars, especially those who have had little or no experience being locked up.
“…all the pretrial detainees are at their highest peak for suicide in the first 24 to 72 hours,” Daniel said. “If they are substance abusing individuals, maybe up to seven days to 14 days.”
Smith said a “mountain of research” points to the heightened danger of the first few days and weeks behind bars. He said many jails will marshal their resources to limit the risk of suicide during this sensitive time.
“...jails should follow the best practice of placing the most surveillance, control, observation, experienced staff and mental health resources… at this crucial period of incarceration,” Smith said in an email.
Of the 22 people, including Howe, court records and news accounts were available for 17 to show how long they had been at the institution before they died. The material shows that eight died within their first 16 days, six within their first six months, the rest between 10 and 20 months.
At least four of these people were sent back to the institution with court papers showing that they were considered a suicide risk.
The signs of potential trouble are often not subtle, according to wrongful death lawsuits filed by two families of people who committed suicide in Bristol County institutions.
Barbara Kice filed suit in February 2018, three years after her son, Brandon St. Pierre, 32, died at North Dartmouth on May 6, 2015. In a suit naming Hodgson, one correctional officer by name and two other unnamed officers, Kice claims that the department showed “deliberate indifference” to “obvious” risks to the safety of St. Pierre, who arrived at the Jail and House of Correction as a pre-trial detainee on April 21, 2015, charged with assault and firearms offenses.
On May 5, 2015, as part of a competency hearing in Attleboro District Court, St. Pierre told a psychologist that he would kill himself if he was not transferred to Bridgewater State Hospital, a secure psychiatric institution, the suit claims. After hearing from the psychologist, the judge had St. Pierre returned to North Dartmouth with an order marked “Q5,” meaning he was a suicide risk.
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The suit claims officers had taken no precautions after St. Pierre returned from the hearing, leaving a bedsheet in his one-person cell. On the morning of May 6, 2015, the suit claims, new orders were faxed from the District Court to the Jail and House of Correction saying St. Pierre was to be transferred to MCI-Shirley, a medium-security state prison. Late on the afternoon of May 6, 2015, he was found hanging from the sheet by a cell window.
The state’s motion to dismiss the case does not address the specific claims, but says that Hodgson is not “direct cause” of the death, and that all parties have immunity from such lawsuits. Court records show the case is still pending.
In a wrongful death suit filed in October 2016, Deborah Taylor also claims that obvious steps were not taken to protect her son, Aaron Brito, who was 31 when he hanged himself after only one night at the Jail and House of Correction.
The suit, which according to court records was settled in 2020, claimed that Brito was addicted to opiates and alcohol when he was brought to North Dartmouth on Oct. 10, 2013. His doctors had told the sheriff’s office that he should be in the jail’s health services unit for a week, the suit claimed.
Instead he was placed in a conventional cell, “alone and unmonitored,” where, the suit claimed, there was no effort to alleviate an array of detoxification symptoms.
“The Sheriff's Office followed all suicide awareness protocols in every instance,” said Darling, the sheriff’s office spokesman. “These protocols are independently reviewed by the National Commission on Corrections Health Care, which has awarded the BCSO national accreditations based on audit and inspection results.”
Experts on this subject including Daniel and Smith, agree that the key to preventing suicides lies largely in the hands of correctional officers.
“Most of the suicides are preventable if the correctional officers recognize the emotional and mental health needs of the individual,” Daniel said.
Asked what he would look at if Hodgson hired him to study inmate suicides in Bristol County, Smith started his answer by talking about the correctional officers.
He would want to know: Are there enough officers to do the job? How difficult is it to keep the institutions fully staffed? What sort of training do the officers receive in spotting suicidal inmates, and responding appropriately? How are the officers doing in their own emotional well-being?
Darling said that since the onset of the Covid pandemic in spring 2020, the agency of some 530 full-time employees, about 300 of whom are correctional officers, has had a tough time hiring people. He said the agency has enough people to fill the front lines, but it’s been a squeeze.
“We’re not short, but we have people working forced overtime,” he said, adding that the sheriff’s office is one of many law-enforcement departments in the country struggling to hire.
Correctional officer recruits spend eight weeks in the academy at North Dartmouth learning all aspects of the job, including whatever training there is on spotting and responding to inmates who seem to be at risk of suicide.
Telephone access, specifically the cost of using a jailhouse phone, has emerged as a point of contention in Bristol County, where the agreement between the sheriff’s office and the company providing phone service, Securus Technologies, became the subject of a lawsuit in 2018.
The sheriff’s office signed the contract with Securus in 2011. In the five years before the contract was signed, the sheriff’s office recorded two suicides. In the five years after, 2012 to 2016, the office recorded 11 suicides. The 2016 suicide not in sheriff’s records but confirmed by the Department of Public Health would make it 12.
Kellie Pearson, whose partner, Michael Ray, hanged himself after nearly two years of pre-trial detention at North Dartmouth in June 2017, sued Hodgson and Securus. The suit filed in Suffolk Superior Court claimed the two defendants pursued “an illegal kickback scheme … that has nearly doubled the cost of telephone calls made from Bristol County correctional facilities.”
A Fall River mental health clinician raising two children on her own, Pearson said in an interview that the cost of the calls had become a burden, but the contact was crucial for Ray’s well-being. Ray, 47, who had already served nine years in state prison for armed robbery years before, was facing charges for three armed robberies in Fall River in September 2015.
“Mental health in general is really difficult for folks right now,” she said. “I think that the phone is their only lifeline to humanity.”
The case moved from state to federal court. In 2020, a U.S. District Court judge ruled in Hodgson’s favor, finding that the state Legislature gave sheriffs the authority to raise revenue from inmates’ phone calls.
Soon after Ray died, Hodgson told the New England Center for Investigative Reporting that he would pursue a thorough review of all suicides in his institutions going back 12 years, 16 deaths in all, according to a story published by WGBH in March 2018. The review period would have included the deaths of St. Pierre and Brito that led to the lawsuits.
Hodgson’s 11-page report came out in January 2018, covering only seven of the deaths, concluding that his staff “did everything right in all cases,” WGBH reported.
“I know people are always looking for somewhere to point the blame to say there must be something wrong with their system,” Hodgson told WGBH at the time, “but we have very high standards here and we're constantly looking for ways to improve.”
That was 2018, two years after Hodgson ran unopposed for a fourth six-year term, with four years yet to go. It was not an election year.
Hodgson’s public remarks recently, and those made over the years by the sheriff and other department officials in news stories on the relatively high rate of suicide in Bristol County institutions, do not suggest that the matter is being taken seriously, said Smith, the University of South Carolina criminologist. He noted comments about drug abuse in the community, about suicides in jails everywhere.
“The biggest concern is the language being used, which seems to be driven by political considerations rather than a reality,” Smith said. “There is denial occurring in this language.”
Arthur Hirsch is a freelance correspondent for The New Bedford Light. Email him at email@example.com.
Email Eleonora Bianchi at firstname.lastname@example.org.