Jail Monitor Looking at Suicide Policies

Milwaukee County Jail. Photo by Jeramey Jannene.

The latest report from the Milwaukee County Jail’s health care monitor focused on a review of the facility’s suicide watch policies.

This report was part of a large public release of Milwaukee County Sheriff‘s Office reports and policy documents for a Milwaukee County Board inquiry into jail policies and practices. The goal of the inquiry is to give policymakers the information needed to consider potential reforms or improvements.

This push from the board followed a string of deaths in the jail in 2022 and this year. The jail has, for some years, had a number of deaths in the facility each year. In the jail’s 2021 health care accreditation report, the monitor notes there were three deaths by suicide during the past year. A U.S. Bureau of Justice Statistics report found that more than half of local jails across the country that are roughly the size of Milwaukee’s had at least one suicide in 2019, and 10% of the 2,845 local jails had a death in 2019.

The third-party health care monitor for the county jail is the National Commission on Correctional Health Care (NCCHC), which is the same organization that provides accreditation to the jail’s health care services. This monitor’s latest quarterly evaluation, issued in June, is technical in nature and paints a picture of a complex set of policies and factors spanning the intake process and mental health care provision that involve placing people at the jail on suicide watch. The review was specifically focused on documentation that may improve the follow-up process for anyone who’s been on suicide watch.

The monitor offered some observations and recommendations for improving the suicide watch process. Both recommendations were focused on the reporting and documentation process that mental health care staff working for Wellpath engage in. In general, they suggested additional documentation following a person on suicide watch, and simplifying scheduling for suicide watch follow-ups, noting that the current system, “appears to be dysfunctional in a system already stressed by understaffing and a substantial workload.”

The sheriff’s office noted in another report to the board that Wellpath LLC, the contractor providing health care in the jail, is struggling with staffing. Wellpath replaced Armor Correctional Health Services. In December 2020, the county board authorized a five-year, $109.1 million contract extension for the company, which is among the largest correctional health care companies in the U.S.

Back in 2019, Armor had been struggling to staff their health care services in the jail. Then Jail Commander Aaron Dobson said, “It is very difficult to hire, it was difficult for us when we self operated, it was difficult for Armor now and it will be difficult for Wellpath, honestly.”

Hiring medical staff to work in a jail setting is difficult, especially at a time when even regular hospitals and clinics struggle to maintain staffing levels. In their recent report to the board, the sheriff’s office noted that the solution to the medical staffing trouble in the jail will likely involve an increase in the cost of the contract with Wellpath.

In 2019, Sup. Sheldon Wasserman, a physician who serves on the state’s medical licensing board, told Urban Milwaukee, that without a very high level of pay, jails are sometimes forced to hire medical personnel who can’t get hired elsewhere because of “long previous records of drug convictions, drug violations, substance abuse issues, psychiatric health.”