New York City medical examiner personnel leave their vehicle and walk to the Manhattan Correctional Center where financier Jeffrey Epstein died by suicide while awaiting trial on sex-trafficking charges, Saturday Aug. 10, 2019, in New York. Credit: Bebeto Matthews | AP

The apparent suicide death of Jeffrey Epstein, who was being held in a New York City correctional facility, was shocking. The 66-year-old financier, who was indicted for sex trafficking, was being held at the federally run Metropolitan Correctional Center when he apparently hanged himself on Saturday.

How, many people wondered, was this possible? If anyone would be a high risk for suicide, it would seem to be a prisoner like Epstein.

Epstein’s death raised many questions and warrants further investigation. We need to focus our attention on what went wrong at the correctional center, which has been plagued with staff shortages and other problems, not on conspiracy theories.

What is learned could help improve policies and practices at correctional facilities across the country, where inmate suicides are too frequent.

In 2014, a total of 621 inmates died by suicide in local jails and state prisons, according to data from the Bureau of Justice Statistics, which has not reported more up-to-date statistics.

Suicide was the leading cause of death in local jails, accounting for more than a third of inmate deaths in 2014. These deaths are also on the rise, increasing 22 percent between 2009 and 2014.

Suicides are also on the rise in state prisons, increasing in 2014 to their highest rate per 100,000 prisoners since 2001. These numbers include federal prisoners held in state prisons.

Because Maine has a relatively small population of incarcerated people, it is hard to track trends, but Maine mirrors the national data with far more suicides in local jails than in state correctional facilities.

There have been 11 suicides in Maine county jails in the last five years, according to data provided by the Maine Department of Corrections. Eight men and three women, ranging in age from 26 to 49, ended their lives while in custody. There were two suicides during that time at the Washington County jail. The remainder were in jails in Aroostook, Cumberland, Franklin, Hancock, Knox, Somerset, York counties and at the Two Bridges facility in Wiscasset. Most of the victims were transported to a hospital, where they died.

There have been two inmate suicides at state facilities in Maine since 2014, one at the Maine state prison and one at the Long Creek Youth Development Center. The youth suicide prompted a review of Maine’s juvenile justice system and calls to shutter the South Portland detention facility.

Inmate suicides are a tragedy and a failure of correctional facilities — and likely numerous other systems. The majority of inmates are dealing with mental health conditions and/or substance abuse. Many also have experienced poverty and trauma.

Prisons and jails take many steps to prevent suicides, beginning when someone first arrives at the facility. During intake, inmates are asked dozens of questions, many of them meant to gauge their mental health status. This screening involves health care professionals.

Inmates are most at risk in the early days of their incarceration when the gravity of what has happened to them — and what they may face in terms of punishment and societal judgment — becomes apparent. Some inmates remain in the intake section of a correctional facility for several days. This section has the highest level of staffing per prisoner, Maine Department of Corrections Commissioner Randall Liberty told the BDN. Liberty was previously the Kennebec County sheriff.

Following national best practices, if an inmate is found to be at risk for suicide, they are monitored 24 hours a day by jail personnel who sit outside the cell. If inmates continue to be at risk, they may be referred to the Riverview Psychiatric Facility, a state-run mental health facility. If an assessment, done by mental health professionals, determines the inmate no longer needs 24-hour a day supervision, they can be stepped down to a 15-minute watch, which entails jail personnel physically seeing the prisoner every 15 minutes. The decision to remove them from such watches is made by medical and mental health personnel, not corrections officials. Standard procedure requires every prisoner to be seen once an hour. Staffing shortages can make this a difficult standard to meet, Liberty said.

Even with this monitoring and staff training in mental health first aid and crisis counseling in Maine correctional facilities, inmates do kill themselves.

Most of the inmate suicides in Maine are attributed to a prisoner showing no signs of harming themselves and missed rounds in the facility, according to Liberty.

The Epstein case shed a light on suicides in jails and prisons. The scrutiny should lead to changes that reverse the deadly trends in U.S. correctional facilities.

If you or someone you know needs resources or support related to sexual violence, contact the Maine Coalition Against Sexual Assault’s 24/7 hotline at 800-871-7741.

To reach a suicide prevention hotline, call 888-568-1112 or 800-273-TALK (8255), or visit