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Expert says inadequate staffing is driving deaths in prisons across the Gulf South

Orleans Parish Prison
Creative Commons Photo courtesy of Bart Everson
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Incarcerated people at the Orleans Parish Prison as seen from the Jefferson Davis Parkway overpass. The prison had an especially fatal weekend recently, officials say it is understaffed.

There has been a surge in deaths in prisons and jails around the Gulf South recently.

In Alabama, eight people died a the William Donaldson Correctional Facility in July alone. The number of deaths at the prison is expected to surpass the 26 people who died there in 2021.

In New Orleans, in June, the Orleans Parish Prison had an especially fatal weekend, when one man was stabbed to death with a makeshift weapon and another died in what’s been deemed a suicide. Orleans Parish Sheriff Susan Hutson called deputies stationed at the city’s courts and elsewhere to the jail, in what has been called an unprecedented move. She said that the facility was understaffed.

And earlier this year, the U.S. The Department of Justice issued a scathing report on Mississippi’s State Penitentiary, also called Parchman Prison, after riots in 2020, left prisoners injured or dead and revealed “grossly insufficient levels of security staff that result in lack of supervision and control.”

These deaths have been attributed, in large part, to staffing issues. Spikes in violence in jails and prisons have also been linked to rises in temperatures. Several counties across the region experienced the hottest June on record. In Louisiana, an advocacy group alerted media outlets that people held at the East Baton Rouge Parish Prison complained of no air conditioning. Meanwhile, Parchman Prison in Mississippi has only just begun to air condition its facility in 2022, after 121 years of operation.

Gulf States Newsroom reporter Bobbi-Jeanne Misick sat down with Loyola University New Orleans Law Professor Andrea Armstrong, who studies prison and jail conditions and deaths behind bars as director of Incarceration Transparency.

Andrea Armstrong
Courtesy of Loyola University
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Loyola University Professor Andrea Armstrong.

Armstrong called staffing, “the most critical” element of keeping jails and prisons safe and secure for the people in their care.

She shared her insight on what questions to ask when people behind bars die. And explained just how seriously prison and jail administration should take climate change and rising temperatures in these Gulf States.

The following transcription of their conversation has been edited for clarity.

Misick: Professor Armstrong, right off the bat, I wanted to ask you, you know, when you hear reports like this of deaths in jails and prisons, what's the first thing that comes to your mind? 

Armstrong: Staffing? Without a doubt it is staffing. It is the most critical aspect of what jails and prisons provide in terms of services.

Misick: At the New Orleans Jail, the Orleans Justice Center in June, we saw two deaths in one weekend, one of someone who was stabbed to death by a makeshift weapon and another of someone who committed suicide. And so Sheriff Susan Hutson called the deputies that were stationed elsewhere back to the jail. How important is that ratio of staff to inmates in a jail setting?

Armstrong: Staffing is critical to being able to provide safety and medical care in jails and prisons. Right. So the people who are inside, they don't have access to a phone to call 911 for help or to reach out to their neighbors. Instead, they are fully dependent on the jail to provide not just security through staffing, but staffing is also on the floor to note where there's a medical emergency to address conflicts before they become violent and to help people engage constructively both with each other as well as in programming.

Misick: Could you explain what the media reports about low staffing at the jail suggest to you? What triggers are set off?

Armstrong: So the first thing to understand about the New Orleans jail and several other jails in the state is that they are direct supervision jails. What that means is that everyone who is detained in a particular wing or area – they are in cells, usually double-bunked. But it's all within an open area.

And the tiers are designed such that you have to have a staff person both in the tier, in that general day area space, but they also have an observation pod at the top where there should be a person who is monitoring the cameras and is available there to call for emergencies. And so the system of supervision really relies on having people in both spots, both in the monitoring pod, as well as on the floor of the tier. What the media reports indicate is that for the deaths in Orleans, there were vacancies on the floor and there may have been vacancies in the monitoring station as well. 

This is really critical. It's like when the teacher's out of the room in the classroom. We all know what happens. Tempers may flare. Conflicts may go unresolved. Emergencies may happen. And in all of those cases, security staff are critical for ensuring that people are safe during those time periods.

Misick: We also saw a death recently in the Baton Rouge jail of a 23-year-old who died of a fentanyl overdose. In your work, how pervasive have opiates become in jails here in the Gulf  South? And what kinds of things do you consider when you hear about those deaths? 

Armstrong: What we know nationally is that deaths related to drug overdoses are at a steep increase. We see that drug overdoses are also a cause of death here in Louisiana, based on the data that we've been collecting. Although it is often the third or fourth leading cause of death and overwhelmingly the first cause of death in Louisiana is around medical illness and deaths from medical or quote unquote, natural causes.

The death in East Baton Rouge Parish Prison is really troubling on a number of fronts. First, this was a person who had been convicted in April. So at least since April, they had been in custody and likely well before that. I mean, this was for a crime that occurred in 2018. So the question has to be, if this is truly a safe and secure facility, how did the drugs enter the facility to begin with? In the news media, you'll see a recent report from Angola, for instance, where they arrested a guard who was bringing in meth through potato chip bags into the facility. And so, it implicates policies around staffing. It implicates policies around security, meaning searches of staff as they come and go from the facility. You know, how else are these drugs getting in, particularly in these closed institutions that don't have a lot of open space?

For the death in East Baton Rouge Parish Prison, it's also troubling because of the proximity, at least of medical care. Out here, when we're not in jails or prisons, if there is an overdose in my home, then I would have to call an ambulance, wait for that ambulance to arrive. That ambulance would then have to take the trip to the nearest hospital. And so there's automatically time built in where a person can be in severe medical distress without necessarily receiving the care that could save their life. In a jail or in a prison, that health care is supposed to operate 24 hours a day and is in the same building. And so that should be a place where the medical response is the quickest and has the greatest potential to save a life.

Here, in this case, it isn't clear that staff were alert to the issues. The media reports indicate that the decedent was found unresponsive in the cell. And so, was the pod adequately staffed? If it was staffed, was that staff person trained in how to recognize signs of medical distress? If they were, did they, in fact, see the medical distress? And where did the delay occur in arranging for the lifesaving care that is possible for drug overdose cases — which then implicates the ability of the medical care services to deliver the necessary care?

Misick: You mentioned that the leading causes of death in jails and prisons in Louisiana are medical reasons and natural causes. And so, I wanted to just ask you to expand on that a little bit. Is that because of the aging population in our carceral spaces?

Armstrong: So we're currently working on the data that we've been collecting over the last year. But what I can tell you from 2015 to 2019 is that overall, 14% of the deaths that occurred during that five-year period occurred in a jail. And that is a total of 786 people that died during that five-year period. When we look at these all together, what we see is that medical causes of death are the leading cause of death behind bars. And that is often with reference to the fact that we have extended sentences in this state and we have a rapidly aging, incarcerated population.

So five years ago, the average age of a person who was incarcerated in Louisiana was about 39 years old. Today, the average age is 44 years old. And so we're increasingly seeing deaths of people who are 55 years and older from the same types of diseases that impact us who are not incarcerated, mainly heart disease and cancer. At the same time, other studies are showing that people who are diagnosed with these types of illnesses while incarcerated, when they receive external care, are presenting with more advanced stages of the disease at younger ages.

So when we think about medical-related illnesses being the leading cause of death, it is primarily a function of two different things – First, the fact that we incarcerate folks for a much longer period of time, and that captures a number of the elderly and those above 55 years and older [and] second, it also implicates the health care that is delivered behind bars.

These are systems that are set up for sick call emergency types of treatments. They're not necessarily set up for the treatment of chronic, ongoing, serious illnesses.

Donaldson Correctional Facility
Gigi Douban, WBHM
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At least 22 people have died while incarcerated at the Donaldson Correctional Facility, a maximum security prison in Jefferson County, Alabama. The facility is on track to surpass last year’s 26 inmate deaths.

Misick: I want to look at other parts of the Gulf South.  Donaldson Prison in Alabama has seen 22 deaths so far this year. Deaths at Donaldson are projected to be higher than last year’s count of 26 for the whole year.  Are you seeing more incarcerated people die across the region? 

Armstrong: So, what I can say is we are seeing an increase in the numerical numbers of death. I haven't yet done the analysis to determine if the rate of deaths has increased because you have to compare the number of deaths against the population that is incarcerated to determine the rate. What we do know is that in Alabama in particular, which you mentioned, there has been a significant number of violent deaths, which nationally are about 2% of the deaths that occur in prisons and jails across the country – so Alabama is on the extreme end of that.

In Louisiana, we have had violent deaths, but they are a relatively small percentage of the overall deaths, according to the facility — and I say according to the facilities because they are the primary determiners of what the cause of death is. So each facility will create their internal investigation after a death. Sometimes they report those to the state or to the federal government. Sometimes they just report it to the coroner and in files that we have collected here at Loyola, we have seen that some deaths that were, in fact, related to violent incidents were coded as either accidental deaths or as medically related deaths. So, I can only kind of share what the facilities themselves are coding the death sets, but it raises a lot of questions around how these causes of death are determined. Are these investigations ever reviewed by an independent authority? And then, you know, what are the facilities doing in response to the results of these investigations to protect people in the future?

Misick: And with regard to Donaldson, you'd look at staffing as well? 

Armstrong: Yeah, absolutely. So one of the claimed advantages of the direct supervision model is that you have people who are on the floor who get to know the people who are in that tier. Because they are there day in and day out, they can recognize and also interrupt before a conflict becomes violent. They get to know the people. They get to know the different personalities. And so staffing is really critical not just for addressing violence once it occurs, but actually in preventing the conflict from getting to a violent stage in the first place.

Misick: Also at the East Baton Rouge Jail a local advocacy group was hearing that there was no air conditioning during one of the hottest times of the year. And I'm just wondering how much you think about climate change and what the Gulf states should be doing to address temperature issues in jails and prisons. 

Armstrong: So I think the first thing to know is that people who are incarcerated are uniquely vulnerable to climate change. So you and I, when it's particularly hot, we are free to adapt to address the hotter temperatures. We can go to a cooling center. We can go to the library, we can change how we dress, we have ready access to water, hopefully ice, as well. So there's lots of things that we are free to do to address the heat and to cope with the heat that they are not free to do. And in fact, if they do them, they can be punished with sanctions, including solitary confinement. So the first is they are just vulnerable in a way that we are not to climate change.

But I think the second point that we have found, and this includes a Vera [Institute] study from 2019 that focused on Louisiana prisons, is that as heat temperatures rise, so do the possibilities for self-harm. And in other studies nationwide, we've seen higher rates of conflict and violence when there are also higher temperatures. So what that means is that if we actually want to operate a safe and secure facility, we have to proactively manage the temperature inside of these facilities because we know that they're linked.

The third thing is that given the prevalence of the elderly in particular, but also people with severe illnesses, medical and mental health, certain prescriptions are interacting negatively with high temperatures and can cause additional medical complications simply because you're taking the medicine that is prescribed to you for your medical or your mental health condition. And so climate change is of enormous importance for the safe and secure operation of a jail or prison, and they have to be proactive about it because of all of these potential consequences.

Misick: Lastly I’m wondering if there’s anything else that I haven’t asked about that you think people should be talking about regarding preventing deaths in incarceration? 

Armstrong: So there's a couple of things that I think we should talk about.

One is, in all of the news media reports around the recent death at East Baton Rouge Parish Prison, none of them mentioned, in fact, how long he had been behind bars, which is a critical question. We're thinking about drugs entering these facilities. Some of them mentioned he had been convicted in April. So we can conclude that he had at least been in since April. But it's possible that he had been there [for] years. And so if we want to understand how these drugs are getting into the facilities, we really have to pay attention to the deaths that are occurring, the overdoses that are occurring, and how long those people have been in facility.

The second thing is, beyond staffing, we do have to think about programming and activities. The day-to-day life of a person who is incarcerated in a jail, in particular, can be at least incredibly monotonous. And it is in those situations where we see conflicts arise, where we see violence occur, where we see self-harm occur, and where we see drug overdoses. And so if we want to provide an environment where those things are discouraged, we want to focus on programming and activities that are available behind bars on a daily basis for the people who are incarcerated.

And then lastly, I would just mention health care and how critical it is that these systems are responsive not just to emergencies like an overdose or medical distress, but that they are equipped to provide ongoing care. And it's really those three things – staffing, health care and programming and activities that shape how secure and safe a facility can be.

This story was produced by the Gulf States Newsroom, a collaboration among Mississippi Public Broadcasting, WBHM in Alabama and WWNO and WRKF in Louisiana and NPR.

Bobbi-Jeanne Misick is the justice, race and equity reporter for the Gulf States Newsroom, a collaboration between NPR, WWNO in New Orleans, WBHM in Birmingham, Alabama and MPB-Mississippi Public Broadcasting in Jackson. She is also an Ida B. Wells Fellow with Type Investigations at Type Media Center.