Suicide watch (sometimes shortened to SW) is an intensive monitoring process used to ensure that any person cannot attempt suicide. Usually the term is used in reference to inmates or patients in a

prison A prison, also known as a jail, gaol (dated, standard English, Australian, and historically in Canada), penitentiary (American English and Canadian English), detention center (or detention centre outside the US), correction center, corre ...

, hospital,

psychiatric hospital Psychiatric hospitals, also known as mental health hospitals, behavioral health hospitals, are hospitals or wards specializing in the treatment of severe mental disorders, such as schizophrenia, bipolar disorder, eating disorders, dissociat ...

military base A military base is a facility directly owned and operated by or for the military or one of its branches that shelters military equipment and personnel, and facilitates training and operations. A military base always provides accommodations for ...

. People are placed on suicide watch when it is believed that they exhibit warning signs indicating that they may be at risk of committing bodily harm or purposefully killing themselves.

Forms

Various forms of suicide watch exist. These generally involve the subject being under continuous or very frequent watch of a guard, such as a prison officer, security officer or

orderly In healthcare, an orderly (also known as a ward assistant, nurse assistant or healthcare assistant) is a hospital attendant whose job consists of assisting medical and nursing staff with various nursing and medical interventions. The highest ro ...

, who will intervene if the subject attempts to harm themselves.

Periodic

''Periodic suicide watch'', or more simply known as ''suicide watch'', involves the subject being monitored through frequent periodic checks.

Intense

''Intense suicide watch'' or observation involves the subject being observed continually by a person who may be employed in one of several possible capacities, sitting or standing in direct sight or arm's reach of the subject. This may be known as a 1 to 1.

Conditions

People under suicide watch are put into an environment where it would be difficult for them to hurt themselves. In many cases, any dangerous items will be removed from the area, such as sharp objects and some furniture, or they may be placed in a special

padded cell A padded cell is a cell in a psychiatric hospital with cushions lining the walls. The padding is an attempt to prevent patients from hurting themselves by hitting their head (or other bodily parts) on the hard surface of the walls. In most case ...

, which has nothing outcropping from the walls (e.g., a clothes hook or door closing bracket) to provide a place for a

ligature Ligature may refer to: * Ligature (medicine), a piece of suture used to shut off a blood vessel or other anatomical structure ** Ligature (orthodontic), used in dentistry * Ligature (music), an element of musical notation used especially in the me ...

to be attached, and with only a drain-grill on the floor. They may be stripped of anything with which they might hurt themselves or use as a

noose A noose is a loop at the end of a rope in which the knot tightens under load and can be loosened without untying the knot. The knot can be used to secure a rope to a post, pole, or animal but only where the end is in a position that the loop can ...

, including belts, neckties,

bras A broadband remote access server (BRAS, B-RAS or BBRAS) routes traffic to and from broadband remote access devices such as digital subscriber line access multiplexers (DSLAM) on an Internet service provider's (ISP) network. BRAS can also be refe ...

shoe A shoe is an item of footwear intended to protect and comfort the human foot. They are often worn with a sock. Shoes are also used as an item of decoration and fashion. The design of shoes has varied enormously through time and from culture ...

shoelace Shoelaces, also called shoestrings (US English) or bootlaces (UK English), are a system commonly used to secure shoes, boots, and other footwear. They typically consist of a pair of String (cord), strings or cords, one for each shoe, finished o ...

s, socks, suspenders,

glasses Glasses, also known as eyeglasses or spectacles, are vision eyewear, with lenses (clear or tinted) mounted in a frame that holds them in front of a person's eyes, typically utilizing a bridge over the nose and hinged arms (known as temples ...

, necklaces,

bed sheet A bed sheet is a rectangular piece of cloth used either singly or in a pair as bedding, which is larger in length and width than a mattress, and which is placed immediately above a mattress or bed, but below blankets and other bedding (such a ...

s and other items. They are only allowed small finger foods and no books. Any large pieces of food like pizza or crumpled pages of a book could be used for suffocation. In extreme cases the inmate may be undressed entirely. In even more extreme cases, inmates may be placed in "therapeutic restraints", a four- or five-point restraint system. The inmate is placed on their back on a mattress. Their arms and legs are tied down and a belt is placed across the chest. In a five-point system the head is also restrained. An inmate is allowed a range of movement every two hours, when one limb is released and they are allowed to move it for a short period. They are then restrained again, proceeding to the next limb. This process is repeated until all areas restrained have been moved. This process usually continues in eight-hour shifts, and the inmate has a face-to-face encounter with a mental health professional at least once in each eight-hour interval. This cannot continue for more than 16 consecutive hours. The inmate is continually watched by staff during this time. In the most extreme cases of self-harm, only when all other avenues have not worked or are impracticable, "chemical restraint" drugs may be used to sedate the inmate. In order for a facility to administer a chemical restraint, it must have the approval/recommendation of a licensed mental health professional, the facility warden, and a court order.

Controversies

Inmates are often placed naked in suicide cells, which are usually bare concrete, often without bedding (to prevent hanging by using bedsheets), and under frequent or continuous observation by guards. Unsanitary conditions are also common since toilet paper, underwear and tampons (all potential means of

choking Choking, also known as foreign body airway obstruction (FBAO), is a phenomenon that occurs when breathing is impeded by a blockage inside of the respiratory tract. An obstruction that prevents oxygen from entering the lungs results in oxygen dep ...

) are restricted. Being exposed without any way of covering oneself, coupled with being under constant observation, can aggravate mental distress, particularly if the inmate has been a victim of sexual abuse. These harsh conditions came to light in 1998 when Elizabeth B., an inmate of

Framingham Framingham () is a city in the Commonwealth of Massachusetts in the United States. Incorporated in 1700, it is located in Middlesex County and the MetroWest subregion of the Greater Boston metropolitan area. The city proper covers with a popul ...

prison in

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, USA, called a radio talk show to describe how she had been treated while on suicide watch:

I was ... put on eyeball status, stripped of belongings, clothing, placed naked in a room with nothing but a plastic mattress on the floor. Watched 24 hours a day by a man or woman. I was on my period but because of my status not allowed to have tampons or underwear. I was very humiliated, degraded. Being on eyeball status with male officers, my depression intensified. I didn't want to be violated any more than I already was, so I put the mattress up against the window. When I did that I was in violation because they couldn't see me. The door was forced open, I was physically restrained in four-point restraints - arms, legs spreadeagled, tied to the floor, naked, helmet on head, men and women in the room.

Being on a suicide watch does not guarantee a person will not kill themself. Ashley Smith, a female inmate at a facility in Canada, killed herself while under suicide watch in October 2007. The circumstances surrounding her death were the subject of the

Ashley Smith inquest The Ashley Smith inquest was an Ontario coroner's inquest into the death of Ashley Smith, a teenager who died by self-inflicted strangulation on 19 October 2007 while under suicide watch in custody at the Grand Valley Institution for Women. De ...

References