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THE HUFFINGTON POST

WASHINGTON ― It’s a familiar story: An inmate takes his or her life inside a prison or jail, and family and loved ones are left wondering how the incident possibly could have happened. This time, the public interest is even higher ― one of the most famous prisoners in America, former NFL star Aaron Hernandez, was found dead in his cell on Wednesday morning, according to the Massachusetts Department of Correction.

Hernandez, 27, was serving a life sentence for the 2013 murder of Odin Lloyd, a semi-professional football player who was dating the sister of Hernandez’s fiancee. That sentence was handed down in 2015, but last Friday, he was found not guilty of a separate 2012 double murder. 

Boston Globe via Getty Images

Former New England Patriots tight end Aaron Hernandez sits at the defense table during his double murder trial in Boston on March 2.

(Note: This article discusses some of the details of the means by which Hernandez killed himself.)

It’s a misconception that there is nothing prisons and jails can do about suicides in custody. Although “not all inmate suicides are preventable, many of them are,” said Lindsay Hayes, a national expert on this issue who previously consulted with the Massachusetts Department of Correction. Hayes also noted that he was “confident” that the agency and its health care provider will conduct comprehensive investigations into Hernandez’s death, and that “should include a transparent determination as to whether or not his death was preventable.”

As the circumstances unfold, there are a number of factors that may help answer that question: Were there any warning signs, and if so, should Hernandez have been put on suicide watch? Did he receive appropriate mental health screening and treatment, if warranted? How often was he supposed to be checked on, and when was his last contact with a correctional officer? Was his prison cell designed with suicide prevention in mind, or retrofitted to reduce ligature points an inmate could use to hang himself?

In the wake of Hernandez’s death, his family is seeking a probe. His former agent said he didn’t believe that Hernandez would kill himself. (It’s not uncommon for friends and family members to be skeptical that a loved one would ever take his or her own life.)

There were 47 suicides in Massachusetts prisons between 2001 and 2014, according to federal data. From 2001-2014, the suicide mortality rate in Massachusetts state prisons was 32 per 100,000 inmates, double the national average of 16 per 100,000 over that timeframe. There were six suicides in 2014, but just one suicide in 2015 and two in 2016, according to Massachusetts Department of Correction data.

The suicide rate in jails is much higher than it is in prison. In state prisons throughout the country, that rate was 20 deaths per 100,000 inmates in 2014, compared to 50 deaths per 100,000 inmates in local jails, according to Bureau of Justice statistics.

Still, prison suicides appear to be on the rise in recent years. The percentage of suicides in state prisons in 2014 was the highest recorded since 2001, and represented a 30 percent jump from 2013 to 2014 ― from 192 deaths in 2013 to 249 deaths in 2014. The suicide death rate in 2014 20 suicides per 100,000 inmates ― was the highest rate recorded since 2001.

Part of the discrepancy between prisons and jails is due to the nature of the confinement. Unlike prisons, jails hold inmates for only short periods of time, and they are dealing with people who may not be used to the shock of confinement, could be withdrawing from drugs or alcohol, and have unknown mental health histories. (A Huffington Post investigation found that nearly a third of jail deaths over a year-long period occurred in the first 72 hours after booking.)

Hernandez wasn’t new to confinement: He was already serving a sentence of life without parole. But his apparent suicide occurred less than a week after he was acquitted on separate charges stemming from the murder of two other people. During the trial, he had contact with his family — including his 4-year-old daughter — in a different capacity than he would have once back in prison. That kind of event is a trigger “that could increase his risk of harming himself,” says Eric Balaban, a senior staff counsel with the National Prison Project at the American Civil Liberties Union. That raises the question of whether Hernandez’s mental health status was evaluated during or after the trial.

A prison spokesman told the Boston Globe that Hernandez had not been on a suicide watch and did not suggest that he planned to harm himself, although it’s not clear on what evaluation that was based. (A Massachusetts Department of Correction spokesperson did not immediately respond to HuffPost’s list of questions about Hernandez’s death.)

The Souza-Baranowski Correctional Center, where Hernandez was held, is a 500,000 square foot maximum-security facility that opened in 1998 at a cost of more than $100 million. It has more than 1,000 cells and 366 cameras. Earlier this year, it was the site of a prison riot where inmates were “getting ready for war,” in the words of one official.

Leslie Walker, the executive director of Prisoners’ Legal Services of Massachusetts, told the New York Times on Wednesday that she considered the prison “troubled” and noted they were “very concerned” about it.

The group sued the state on behalf of inmates in December for allegedly unlawfully segregating mentally ill inmates in solitary confinement, which can exacerbate mental health issues and make inmates more likely to commit new crimes when they’re released. The suit alleged that Department of Correction officials were downgrading the diagnoses of mentally ill inmates, making them eligible to place in segregation.

The physical plan of a prison, as well as whether inmates have direct supervision from staff, can also be key factors in preventing suicides. We do not yet know how often Hernandez was supposed to be checked on by staff, or when he actually was.

Hernandez was found hanging by a bedsheet tied to the cell window, and it’s unclear whether the window had been designed to prevent suicide. For the cell window to be suicide-resistant, any security bars should have been flush with the window or covered, or the gap between the bars and the window should have been eliminated, according to a guide issued by Hayes on suicide-resistant cells.

Hernandez was also in a single cell in a general population unit at the time of his death, according to prison officials, which can also be a risk factor.

As the investigation into Hernandez’s death is ongoing, authorities and Hernandez’s family are still searching for answers. “There were no conversations or correspondence from Aaron to his family or legal team that would have indicated anything like this was possible,” said Jose Baez, a lawyer for Hernandez.

If you or someone you know needs help, call 1-800-273-8255 for the National
Suicide Prevention Lifeline. You can also text HELLO to 741-741 for free,
24-hour support from the Crisis Text Line. Outside of the U.S., please
visit the International Association for Suicide Prevention for a database
of resources.