DOI: 10.3886/icpsr03925.v1
title: Suicide and Risk Behaviors in an Incarcerated American Indian Population in the Northern Plains [United States], 1999-2000
title: Version 1

description: This study was initiated by the administrator of a county
jail in the Northern Plains of the United States who was concerned
about the incidence of suicide behaviors in that facility,
particularly among the American Indian population. It was a two-year
project designed to evaluate the existing admissions suicide screening
tool and to improve the instrument's cultural relevance for the
American Indian population. The existing screening instrument used in
the county jail to interview inmates at their intake was developed in
New York. The main objective of the first year of the project was to
determine if that instrument was culturally appropriate for the jailed
American Indian population. The principal objective of the second year
of the project was to determine whether the employment of different
suicide screening protocols would make a difference in the responses
of new detainees with regard to the likelihood of securing their
honest reports of experiencing suicide ideation and its associated
risk factors. For the duration of the project, all male and female
inmates aged 18 and older who were booked into the jail went through
the customary booking procedure that included the administration of
the New York Suicide Prevention Screening Guidelines. In the first
year of the project, researchers also administered a short self-report
survey consisting of measures commonly associated with suicidal
ideation. The self-report survey measured stress, anxiety, suicide
ideation, hopelessness, and suicidal behavior history. The protocols
in the second year of the project reflected efforts to test different
screening conditions for four experimental groups and one control
group of new detainees. The outcome variables of the short self-report
survey consisted of measures of demographics, comfort experience
during booking and the screening process, self-efficacy and management
of depression, knowledge of mental health support available within the
jail, and general well-being. In addition to the quantitative data
collection, qualitative data were also collected to develop a
straightforward assessment of suicide ideation criteria in this
specific jail setting using semi-structured focus group interviews.
description: This study was initiated by the administrator of
 a county jail in the Northern Plains of the United States who was
 concerned about the incidence of suicide behaviors in that facility,
 particularly among the American Indian population. The county jail is
 situated within the center of the region in which the contemporary
 Plains Indian tribes reside. It houses persons arrested for
 misdemeanor and felony charges and, by contract, persons incarcerated
 under the jurisdiction of federal authorities. Approximately 45
 percent of the yearly average intake bookings into the jail are
 American Indians. However, in 1996 there were 17 total suicide gestures
 in this facility and over 75 percent of them involved an American Indian.
 This study was a two-year project to evaluate the existing suicide
 screening protocol and improve it for use with the American Indian
 incarcerated population. Because the admission screening tool used in
 the county jail to interview inmates at their intake was developed in
 New York, one research objective was to determine if that instrument
 was culturally appropriate for use with the county jail population,
 particularly with the American Indian population. This endeavor
 involved exploring the connection between American Indian and
 non-Indian inmates' responses to suicide screening questions as they
 were asked within the jail setting. The specific objectives of the
 first year of this research project were: (1) to determine the
 prevalence rates of suicide ideation within and between American
 Indian and non-Indian jail populations, (2) to examine concordance of
 the current screening tool used in the county jail with other
 self-report measures of suicidal ideation and associated risk factors,
 (3) to examine the cultural relevance of the current suicide risk
 screening tool and of the intervention methods employed in response to
 suicidal behavior within this particular jail setting, (4) to develop
 measures of culturally-specific symptoms of suicide ideation that
 could be incorporated into a suicide screening protocol, and (5) to
 provide recommendations for culturally-sensitive suicide ideation
 detection and intervention or treatment policies in this detention
 setting. The principal objective of the second year of this research
 project was to determine whether the employment of different suicide
 screening protocols would make a difference in the responses of new
 detainees with regard to the likelihood of securing their honest
 reports of experiencing suicide ideation and its associated risk
 factors. In particular, the research goals of the second year were:
 (1) to identify, through the use of an experimental design, a suicide
 screening process that influenced Northern Plains detainees' comfort
 level in disclosure of suicidal ideation as well as future
 help-seeking behavior and depression management within the jail
 setting, and (2) to determine if the wording and format of screening
 questions and the type of screener made a difference in the detainees'
 comfort level for self-disclosure, management of depression, and
future help seeking behavior.
description: For the duration of this two-year research
 project, all male and female inmates aged 18 and older who were booked
 into the jail went through the customary booking procedure that
 included the administration of the New York Suicide Prevention
 Screening Guidelines (NYSPSG) questionnaire. Developed in New York and
 implemented in New York jails and lockups in 1986 in response to
 systemic problems thought to be contributing to a high rate of suicide
 in those facilities, the NYSPSG instrument was designed to assess two
 groups of risk variables: (1) factors enhancing the level of risk at
 the time of booking, and (2) demographic and personal characteristics
 correlated with suicide risk. This questionnaire was the suicide risk
 detection tool historically used in this detention center. Consistent
 with accepted jail practice and with the legal and correctional
 literature, these questionnaires were always completed prior to the
 inmate being asked to participate in the research. During the sampling
 periods, all new prisoners who gave their informed consent were given
 a self-report survey after they had been interviewed using the NYSPSG
 questionnaire. In Year One (Part 1, Year One Data) researchers
 administered a short self-report survey consisting of measures
 commonly associated with suicidal ideation. With the exception of the
 relatively few self-report surveys completed early in this project,
 which were completed just prior to the detainee being moved into his
 or her housing unit, all self-report surveys were completed in the
 booking area within approximately four hours of admission into the
 jail. The self-report survey measured stress, anxiety, suicide
 ideation, hopelessness, and the suicidal behavior history of both the
 inmate and his or her family. The protocols in the second year of the
 project (Part 2, Year Two Data) reflected efforts to test
 different screening conditions for four experimental groups and one
 control group of new detainees. Each group was assigned to a specific
 data collection period during which inmates admitted into the jail on
 a certain day and during a certain time period were considered
 potential participants. The control group consisted of inmates booked
 under normal procedures without any change to the assessment tool or
 process already in use in the jail. Additionally, for those subjects
 included in the control group, there were no changes made in the
 characteristics or credentials of the person doing the screening, nor
 was there a change in the type of setting in which the screening
 occurred. The use of this control group allowed for an accounting of
 the effects of each of the subsequent four experimental groups. The
 first experimental group consisted of new detainees screened in a
 private area of the booking section of the detention center by a
 uniformed officer. The second experimental group was comprised of all
 incoming inmates being screened by an American Indian officer in the
 more private area of the jail. The third experimental group had
 incoming inmates screened in private by someone with a credentialed
 mental health background. The fourth experimental group consisted of
 all incoming inmates being screened in private by a non-uniformed
 American Indian. The outcome variables were included in a short
 self-report survey consisting of measures of demographics, comfort
 experience during booking and the screening process, self-efficacy
 management of depression, knowledge of the mental health support
 available within the jail, and general well-being. All study
 participants were asked to complete this self-report survey after
 their booking and screening process was complete and just prior to
 either their release on bond or their transfer to housing units within
 the detention center. Part 2 of this data collection contains the
 quantitative responses to the Year Two questionnaire, while Part 3,
 Year Two Open-Ended Responses, contains the open-ended responses for
 the question asking the respondents' opinions about the Year Two
 questionnaire. The quantitative data collection was supplemented with
 qualitative data during both years of this project. The goal of the
 qualitative portion of the first year research endeavor was to develop
 the most straightforward assessment of suicide ideation criteria in
 this specific jail setting using semi-structured focus group
 interviews. The first three focus groups during Year One discussed the
 NYSPSG screening instrument, examining each item through probative
 questions. These focus groups were conducted with American Indian
 males (Part 4, Year One American Indian Male Focus Group Data on
 NYSPSG), American Indian females (Part 5, Year One American Indian
 Female Focus Group Data on NYSPSG), and non-American Indian males
 (Part 6, Year One Non-American Indian Male Focus Group Data on
 NYSPSG). The second set of focus groups in Year One reviewed the
 jail's suicide prevention policies and procedures. These focus groups
 were conducted with American Indian males (Part 7, Year One American
 Indian Male Focus Group Data on Jail Policies), American Indian
 females (Part 8, Year One American Indian Female Focus Group Data on
 Jail Policies), non-American Indian males (Part 9, Year One
 Non-American Indian Male Focus Group Data on Jail Policies), and
 non-American Indian females (Part 10, Year One Non-American Indian
 Female Focus Group Data on Jail Policies). Every inmate participant's
 informed consent was obtained prior to initiation of the group process
 and questioning. Focus group discussions generally lasted one to two
 hours. All focus group discussions were audiotaped and later
 transcribed and summarized. Lastly, a focus group comprised of
 officers having primary responsibilities in both the intake and
 housing areas of the jail was held (Part 11, Year Two Officer Focus
 Group Data). A semi-structured questioning method which allowed for
 the pursuit of emerging themes was utilized. The officers' focus group
 lasted nearly two hours and occurred after their evening shift, from
approximately 11:00 p.m. to 1:00 a.m.
description: Demographic variables in Part 1 include age,
 gender, ethnic identity, tribal affiliation, education level, income,
 marital status, number of children, religious beliefs, and official
 charges for arrest. Respondents were also asked about their previous
 arrest history, experience being jailed, and experience being
 hospitalized for emotional or substance abuse problems. Other items
 measured the severity of suicidal ideation, the extent of social
 support from significant others, and the types and amount of help
 received from resources other than family or friends for emotional
 support, substance abuse, domestic violence, anger control, or health
 problems. Additionally, respondents provided descriptions of anxiety
 symptoms, measures of loneliness, amount of stress from being in jail,
 and negative attitudes about the future. They also answered questions
 about their personal suicidal behaviors and those of their family
 members. Lastly, respondents provided information on traumatic life
 events and coping mechanisms. In Part 2, demographic information
 included age, gender, ethnic identity, tribal affiliation, and pending
 criminal charges. Additional questions inquired about the inmate's
 comfort and truthfulness response levels during the screening
 process. Other questions asked about the inmate's self-efficacy to
perform self-management behaviors for depression.
description: Response Rates: Not Applicable.
description: Presence of Common Scales: Part 1 includes the Beck Scale for Suicide Ideation (SSI),
 Beck Anxiety Inventory (BAI), Beck Hopelessness Scale (BHS), Jail
 Stress Scale, a scale of spiritual or religious beliefs developed by
 the National Center for American Indian/Alaska Native Mental Health
 Research, Scale of Perceived Social Support, UCLA Loneliness Scale,
 Brief COPE Scale, and the Stressful Life Events Screening
 Questionnaire. Part 2 includes some questions from the Self-Efficacy
 Control/Manage Depression Scale of the Stanford Patient Education
Research Center.
description: For Part 1, all inmates brought into the jail were given
 an explanation of the research project and asked to sign the informed
 consent form and take the survey in a reasonably private but
 supervised space in the booking area. Rather than place a time limit
 on the sampling, the administrator and shift supervisors agreed to
 allow for ongoing sampling until a sufficient number of subjects was
 obtained. Except for a four week period between December 14, 1999, and
 January 13, 2000, detainees coming into the jail were asked to
 participate in the study. Exclusion criteria included those who were
 not proficient in reading and understanding the English language. The
 sampling period for the second year of research (Parts 2 and 3) was
 initiated in October 2000 and continued through May 31, 2001. Several
 sampling strategies were employed and these varied according to the
 intake protocol used by the booking officer after she or he received
 specific training in the nature and purpose of the study and the
 protocol to be used during the data collection period. In the initial
 months of the study period, using the jail's customary intake
 procedures, baseline data were collected by asking every inmate who
 was admitted into the jail to participate in the study by completing a
 Feedback and Satisfaction Survey after having been through the routine
 booking process. For Parts 4-11 a convenient, qualitative purposive
 sampling strategy was used. The jail mental health counselor
 approached detainees who she thought would be able to contribute to
 the focus group discussion. She described the study and asked for
 participation. Once the detainee agreed, their names were then added
 to a list that the officers used to "call out" when the focus groups
where convened.
description: Datasets: 
DS0: Study-Level Files
DS1: Year One Data
DS2: Year Two Data
DS3: Year Two Open-Ended Responses
DS4: Year One American Indian Male Focus Group Data on NYSPSG
DS5: Year One American Indian Female Focus Group Data on NYSPSG
DS6: Year One Non-American Indian Male Focus Group Data on NYSPSG
DS7: Year One American Indian Male Focus Group Data on Jail Policies
DS8: Year One American Indian Female Focus Group Data on Jail Policies
DS9: Year One Non-American Indian Male Focus Group Data on Jail Policies
DS10: Year One Non-American Indian Female Focus Group Data on Jail Policies
DS11: Year Two Officer Focus Group Data
description: All inmates and officers in a county jail in the Northern
Plains of the United States. Smallest Geographic Unit: none
description: Data collected from jail booking records including the New York Screening form resulted in a large amount of missing values. Thus, data used from these variables should be used with extreme caution.Information about how to obtain the survey instruments used in Part 1 of this collection can be found in the codebook.The user guide, codebook, and data collection instrument
are provided by ICPSR as Portable Document Format (PDF) files. The PDF
file format was developed by Adobe Systems Incorporated and can be
accessed using PDF reader software, such as the Adobe Acrobat
Reader. Information on how to obtain a copy of the Acrobat Reader is
provided on the ICPSR Web site.