Editor’s note: This story focuses on suicide, self-harm and other topics related to psychiatric distress. If you or a loved one is in crisis, resources are available here.

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On Aug. 2, 59-year-old Allen Duane McNutt became the fifth person incarcerated in the downtown Seattle jail to die by suicide in the past year.

Suicides are the leading cause of deaths in jail here and nationwide, but the number of suicides at the Seattle jail — one of two adult jails run by King County — is extreme, experts say.

The rate of suicides at Seattle’s jail since August 2021 has far exceeded national averages from before the COVID-19 pandemic, according to the most recent data available. Between 2000-2019, local jails across the country averaged an annual suicide rate of 49 for every 100,000 people in jail. In the 12 months before McNutt’s death, six people died at the Seattle jail, four of them by suicide.

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Though King County Jail officials say only two of the four suicide deaths would be counted toward those statistics, since the other two victims were released from custody while in the hospital, that would still put King County’s rate at more than four times the national pre-pandemic average. If all four deaths were counted, it would be eight times the average.

“It’s astronomical,” said Frances Abderhalden, an expert on jail suicides and an assistant professor of criminal justice at California State University, Los Angeles. “It begs the question to me: Why this facility? That’s a lot of death in general in one facility per year.”

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The isolation of the COVID pandemic has created alarming conditions within jail walls: While COVID restrictions have lifted in most public places, incarcerated people are dying at a time when in-person visitation at the jail is largely shuttered, group programming is suspended and understaffing has meant that people are staying in cells alone for 23 hours a day. 

At the same time, King County’s average daily jail population and length of stay have steadily increased this year. As of last month, the average daily population in the downtown jail increased to more than 1,200 people — larger than the highest pre-pandemic counts in 2019. Public concern about crime is high and King County mayors are pushing for the jail to accept more bookings. 

Meanwhile, elected officials have made few changes to support inmates’ mental health, announcing no specific plans to restore visitation and programming, and moving slowly on facilities fixes that could prevent deaths.

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Family members of incarcerated people say they worry about loved ones they’re unable to visit, particularly family members who are already diagnosed with serious mental illnesses. The downtown Seattle jail has long been one of the county’s main interventions for people in crisis: Without a more robust mental and behavioral health system, the only way many people end up getting access to help is by getting arrested. 

But family members say it’s only making their loved ones sicker.

Marilynn, a mother of a man formerly incarcerated in the King County Jail this year who was recently discharged from a psychiatric hospital, said she felt helpless and afraid as her son decompensated in jail. She declined to put her last name in print to protect his identity.

Marilynn said that without visitation her son had “nowhere to hold onto reality.” Upon release from the jail, his hands trembled and he looked close to passing out, she said.

“He didn’t even recognize me,” she said. “He just had this blank look on his face.”

“It’s like, what did they do to him in there?”

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Warning signs of suicide

If you are experiencing suicidal thoughts or have concerns about someone else who may be, call the the 988 Suicide & Crisis Lifeline at 988 or 1-800-273-TALK (8255). You will be routed to a local crisis center where professionals can talk you through a risk assessment and provide resources in your community. The more of the signs below that a person shows, the greater the risk of suicide.
  • Talking about wanting to die
  • Looking for a way to kill oneself
  • Talking about feeling hopeless or having no purpose
  • Talking about feeling trapped or in unbearable pain
  • Talking about being a burden to others
  • Increasing the use of alcohol or drugs
  • Acting anxious, agitated or recklessly
  • Sleeping too little or too much
  • Withdrawing or feeling isolated
  • Showing rage or talking about seeking revenge
  • Displaying extreme mood swings
Source: 988 Suicide & Crisis Lifeline

Isolation

Four of the suicide deaths since August 2021 had two things in common.

First, they took place in single cells. They were also among people in the general population, not on the floor where people with serious mental illnesses are housed under closer supervision. 

Isolation is a key factor in suicidal behavior, experts say. Connectedness, or face-to-face interaction with a support system, keeps people alive.

“Phone calls and Zoom calls just [aren’t] the same,” Abderhalden, the suicidologist, said.

The King County Jail started housing people primarily in single cells at the outset of the pandemic as a way to reduce COVID transmission rates. King County auditors last year also recommended avoiding double bunking to prevent violence among people sharing housing units.

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At the same time, the jail suspended group programming to prevent the spread of COVID. But while many group activities on the outside have resumed, programs inside the jail — like Narcotics Anonymous, Alcoholics Anonymous, group religious services and GED courses — have not.

“Loneliness, boredom and hopelessness are all tied into those two policies of visitation and programming,” Abderhalden said. By removing opportunities for connectedness, she added, the jail is “amplifying” factors that contribute to suicidal behavior.

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A major part of the jail’s suicide-prevention strategy is to ask people whether they’re considering suicide or have been recently suicidal before they’re booked. Another screening during booking is also meant to identify people with serious mental illnesses. 

But people might not want to reveal their symptoms, particularly if it means more restrictive housing in the psych unit. Screening for active suicidal thoughts also doesn’t take into account the fact a person might become suicidal while in jail.

Even for those who do already have diagnoses of serious mental illnesses, family members say it’s clear the jail setting has exacerbated their conditions.

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“They have no exercise. They have no activities. There’s not even a radio available,” said Abe, another parent of an adult with serious mental illness incarcerated in the Seattle jail. “A substantial number of individuals with severe mental illness are in the jail, and when we’re talking about suicide risks, the biggest risk is despair.”

Jail spokesperson Noah Haglund said the jail plans to restart in-person visitation and programming when staffing is appropriate, but offered no specifics on what benchmarks would be used to change those policies.

“We are working to bring back these activities as soon as we are confident that we can do so safely,” Haglund said by email.

Med stat three

When staff and incarcerated people witness suicide attempts or death inside the jail, it can create a chain of trauma that passes on to others. Nightmares and hypervigilance, two symptoms of post-traumatic stress, are common, several people told The Seattle Times. 

Staff and incarcerated people hear “med stat three” called over the loudspeaker — the code for severe or life-threatening emergencies — and they know what follows.

Several people heard or saw 34-year-old Erick Hernandez-Mendoza dying of an accidental overdose on the ninth floor of the Seattle jail in February.

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He was convulsing in the toilet area, right by the bunk where one man, who declined to have his name published for fear of retaliation in the jail, had been sleeping.

Since that morning, the man who witnessed Hernandez-Mendoza dying said he’s had nightmares. He has asked to see a psychiatrist and have his bunk moved away from the toilets, which is where the scene replays in his head. 

It’s not like it just goes away,” the man said.

Mental health resources from The Seattle Times

A second man recently incarcerated in the jail who witnessed Hernandez-Mendoza’s death — and who also declined to have his name printed for fear of retaliation — said the death shook his sense of safety. People incarcerated in the jail are at the mercy of whether staff care enough to do something if they’re hurt, he said.

“You’re always thinking somebody’s out to harm you,” he said. “Or overlook what happened to you by another inmate.”

Shana Cantoni, who worked as a psychiatric nurse practitioner at the jail for 10 years, also remembers the calls over the loudspeakers.

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“I would have a physiological response when the loudspeaker would come to life and would find myself saying, please don’t be a med stat three,” Cantoni said. 

Over time, burnout and the devaluing of mental health care in the jail, according to Cantoni, pushed her to leave in 2021. During COVID, the jail required psychiatric providers like her to see people in their housing units for psychiatric assessments or treatment, where others could overhear their conversations, instead of in the jail’s clinic. There was little to no privacy for the people she was seeing.

“I interpreted this as the county having little interest in whether or not inmate patients had access to psychiatric provider services,” Cantoni said.

The jail disputed this characterization, saying the changes to how psychiatric providers saw patients were “medically necessary to prevent a COVID-19 outbreak and have absolutely no bearing on how much the County cares about mental health.”

“The County values mental health care in the jail and strives to provide the best services possible to those in our care and custody,” Haglund, the jail spokesperson, said.

Witnessing death, suicide or suicide attempts also stresses the jail’s population of corrections officers — a group already dealing with severe understaffing. Since the beginning of 2020, staff vacancies have risen from 25 open positions to nearly 100 — almost a fifth of the jail’s corrections officer workforce — and jail officials say the staffing shortages affect opportunities for visitation and getting people out of cells. 

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Dennis Folk, president of the King County Corrections Guild, said a colleague went on extended leave to seek mental health treatment after witnessing two suicide attempts at the King County Jail in Kent.

“These things build up over time and I think this contributes to our really high PTSD and suicide rates within our profession,” Folk said.

Abderhalden, the suicidologist, said seeing suicide, or being exposed to it, can increase a person’s risk for suicide even if they hadn’t previously had suicidal thoughts or behaviors. 

In an intimate setting like a jail, even one death can profoundly affect dozens of people, she said. Not just corrections officers, nurses and attorneys, but also their families — the people who then deal with their loved ones’ trauma exposure at work and coping mechanisms at home.

“If they’re returning back to the community, that’s going to trickle out,” Abderhalden said. 

Prevention

Experts say suicide prevention in the jail should include three things: researching deaths that occur to identify common factors, suicide-proofing the jail setting as much as possible and decreasing emotional and social isolation.

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“If they’re going to be housed alone, [make] sure there’s nothing they can do in that setting to take their life,” said Lanny Berman, former executive director of the American Association of Suicidology and current adjunct professor of psychiatry at the Johns Hopkins University School of Medicine. 

After The Seattle Times published a report showing that the jail was not complying with a new state law to make information about jail deaths public earlier this year, the King County Jail started making its internal reviews of deaths public on a website. 

But despite the growing rate of deaths in the downtown Seattle jail — and the March 2022 announcement of a $750,000 settlement to the family of a man who said the county did little to prevent his suicide — officials have made few efforts to decrease isolation and make sure people aren’t being placed in cells with suicide risks.

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Elected officials who govern the jail — the Metropolitan King County Council through its budget and King County Executive Dow Constantine through his administration — agree that in-person visitation and full programming should return sooner rather than later.

COVID and severe understaffing, however, have postponed that. As of Aug. 23, the jail had 17 adults with COVID in custody.

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“I understand why some of these things were impacted by COVID and undoubtedly they’re having staffing challenges now, but it would be my position that we should get back to full programming and full visitation access as soon as possible,” King County Councilmember Claudia Balducci said. 

But it’s unclear when in-person visitation and programming will resume. In June, former jail director John Diaz told the Metropolitan King County Council the jail was working on a program to give people electronic tablets while visitation and programming are limited. 

The jail also continues to place people in cells with known suicide risks. Three suicides since August of last year involved bunks that officials identified as having a structural problem giving people the means to hang themselves. 

The jail began retrofitting those bunks in 2021, but is not scheduled to finish fixing them until 2023. In the meantime, it is still placing people it doesn’t identify as suicidal in cells with unfixed bunks.

“I would prefer that no one — even those assessed not to be at risk of suicide — be placed in a cell with a yet-to-be retrofitted bunk, but given the number of people in custody and the number of bunks available, that is not a realistic possibility,” Constantine said in an emailed statement last month.

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Political shifts

In July 2020, amid historic racial justice protests, Constantine pledged to close the downtown Seattle jail. He called the facility, which was built in the ’80s, “decrepit and expensive to operate.” The county also operates a smaller jail, called the Maleng Regional Justice Center, in Kent. No deaths have been reported there in 2021 or 2022.

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It’s unclear, however, what timeline Constantine has for closing the downtown jail. And since Constantine made that pledge, an uptick in crime in Seattle has reconfigured the debate around public safety and resulted in more people being booked.

Constantine has pointed to police, judges and prosecutors as the ultimate arbiters of who gets brought to jail — not his administration’s Department of Adult and Juvenile Detention. 

“The solutions are more complex than refusing to book people suspected of committing serious crimes,” Constantine said in the statement. “They involve work to reduce the underlying conditions that lead to crime, and intervening in the lives of those who have gotten into trouble to get them back on track.”

Over the past two years, budgets passed by the Metropolitan King County Council have divested about $1 million from the jail in anticipation of keeping the jail population at COVID-era levels and closing one of the floors. Yet since those budgets passed, the county’s overall average daily jail population increased to more than 1,500 as of last month — more than 20% over what was budgeted for. 

King County Councilmember Girmay Zahilay, who chairs the council’s law, justice, health and human services committee, told The Seattle Times that having discussions about jail alternatives has become much trickier politically in 2022 than it was in 2020. 

Politicians are increasingly blaming the Black Lives Matter and defund movement for heightened crime and visible poverty, Zahilay said, rather than the effects of the pandemic.

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“Whether you point to jails, hospitals, or shelters, many of our reactionary institutions are far over capacity,” Zahilay said by email. “When we don’t properly invest in the long-term health, housing, and safety of our communities, the reactionary solutions will quickly hit their limits and fail to maintain any kind of sustainable success.”

In February, both public defenders and corrections officers told the Metropolitan King County Council the jail needs to decrease the number of people in its care. “We’re unable to provide the very basic care to the inmates in our custody,” Folk, the corrections guild president, said. 

Since then, the council has held one briefing about the spate of deaths. 

In July, Constantine said he asked the detention department earlier in the year to review strategies for preventing suicides. Department officials replied “that they had already implemented widely-held best practices.”

Seattle Times researcher Miyoko Wolf contributed to this report.