Scenes of Prison
42. Suicide and Five-Pointing
“I was sitting through another week at the Training Academy for my annual refresher training last week, and during the lesson on suicide we got into a pretty intense discussion,” said Richard. “ I wanted to run some ideas by you.”
It was another Tuesday lunch, and as we unwrapped our sandwiches, Richard introduced our topic for the day.
“One of the people in our class knew someone who had committed suicide, and it turned out a few others had, too, so we were all paying close attention, and it got kind of emotional.
“The explanation of suicide presented to us by the instructor in the class seemed pretty simple,” said Richard, “maybe too simple, and between the discussion and the lesson, it got me thinking. I think there’s more to it than just someone getting depressed. So, here goes. Tell me what you think of this,” he said. “It’s my new theory explaining suicide.
“Suicide is a contagious mental disease. It infects through the communication of the idea of suicide, and everyone is infected with it. We also keep spreading this contagious disease around by repeating the idea of suicide. I’m spreading it to you right now,” he said to us, “just as I might give you a cold.”
“The body has a natural immunity to suicide which protects us, and I call this immunity ‘the will to live.’ The will to live is very strong in nearly everyone, and it can be strengthened and weakened. Depriving someone and making them uncomfortable or putting them in danger strengthens it. I don’t know what might weaken it. I guess sad things like getting locked up or ending a relationship. You guys can give me some ideas on that.
“But occasionally, for some people, the will to live temporarily weakens, and when it does, symptoms of the suicide infections that everyone carries can emerge into a full-blown illness. It’s similar to when staff bacteria migrate from our skin surface to the inside of our bodies through a break in the skin or a weakened immune system. We always have staff bacteria on our skin, but when it gets a foothold inside, it makes you really sick, and it can kill you. We always have the suicide infection in our minds, too, but when the will to live weakens, the disease manifests itself, and it can kill you, too. Then, a person has feelings of hopelessness and episodes of suicidal ideation: thoughts, plans, and actions to carry through with a violent act which intends to end one’s own life. It’s a dangerous effect, so the contagious mental disease of suicide can be fatal,” said Richard.
“Our instructor at the academy told us we should ask if we think inmates might be thinking about suicide, but that got me worried that we would infect inmates who came to us for help. Here they are at vulnerable moments in their lives when their will to live has been weakened, and they come to us for counseling, and we end up infecting them with this fatal mental disease of suicide. If an inmate commits suicide after coming to us, and we ask about suicide, will we be responsible for the suicide?,” he asked. “Have we caused it by asking about it? Have we killed them?”
“Yikes!,” I said. “That explains Jerry.”
“Who’s Jerry?,” asked Benjamin.
“Jerry was an inmate in our Disciplinary Segregation Unit,” I said. “I think you just described him.”
“Jerry was mentally handicapped and emotionally fragile. His mood could turn very quickly,” I said, “but most of the time, he was jovial and solicitous. Every day, I could count on Jerry asking me ‘How’s your day going, Mister Larsen?’ as he stood at his door and watched us come and go.
“But occasionally, something snapped in him,” I said, “and he became a basket case. He had large jagged scars that climbed the insides of both of his arms and his neck. They were silent testimony to the self-harm episodes he’d been through. It was this unpredictability that had led him to be housed in the Disciplinary Segregation Unit, and he responded very well to the increased control and tight schedule of our Unit, so the Mental Health people were in no hurry to move him out.”
“One day, we talked about suicide. I brought up the subject, and I shouldn’t have done it. As soon as I raised the subject, I regretted it. I had the same lesson you did at the Training Academy, but they never suggested we just bring up suicide as a general discussion topic.”
“So, what happened?,” asked Richard. “Did he kill himself?”
“We didn’t talk about suicide very long, and he wasn’t sad or suicidal and hadn’t been since he came to our Unit,” I said, “and very soon, I changed the subject, and we went on to other topics. When I left that day, Jerry called after me. ‘Have a good night, Mister Larsen.’ I thought he was okay.
“The next morning,” I said, “when I arrived at work, Jerry’s room was empty. Jerry was five-pointed in the hospital at the Diagnostic and Evaluation Center.”
“Five-pointed?!” remarked Richard. “What’s that?”
“That’s exactly what I asked when they told me,” I said.
“Had he tried to kill himself? Did he hurt himself again?,” asked Benjamin.
“Apparently, Jerry had been five-pointed before, and he knew he needed to be five-pointed the, so when he told second shift staff, they took one look at the scars on his arms and neck and didn’t argue with him. A few phone calls later, Jerry was on his way to the hospital,” I said.
“So what is five-pointing?,” repeated Benjamin.
“It’s an emergency psychiatric intervention that prevents suicide.
“If the Mental Health OD (Officer of the Day) believes a person is in danger, he can ask medical staff to intervene. If medical staff on duty choose to do so, they will contact a psychiatrist, and the psychiatrist can order an intervention to take control of an inmate to protect him from himself,” I said. “The first step is to put him in the hospital, take all of his clothes from him, and they place him in a bare room by himself with a suicide blanket for warmth. In extreme cases, when that isn’t enough and they believe an inmate is in imminent danger of seriously harming himself even if he is locked in a room with only a suicide blanket, they can still act to prevent him from harming himself. For example, if he was really determined, he could take a run at the far wall of his cell and break his neck. In a case like this, they can make it impossible for him to act at all. They do that by going to the next step in controlling his actions; they five-point him. When they five-point a patient, they strap him down to a bed in a hospital room, and he can’t even move his head.”
“Sounds like torture to me,” said Richard. “We do that!?”
“I wouldn’t like to have that done to me,” said Benjamin.
“Medical doesn’t use five-pointing very often, and it doesn’t last very long,” I said, “and yes, inmates who are five-pointed do experience it as very punishing. They might agree that it is torture, but as soon as they agree that they will not use a free arm to harm themselves, then the nurse frees an arm. As soon as they agree to stop banging their heads against solid objects like a table top, then their heads are freed, too. And so it goes with the rest of their bodies.
“Medical and our Mental Health Department have found that it is helpful to take control of inmates when they are a danger to themselves, and then give self-control back to them when they demonstrate that they can use it,” I said.
“Your new theory, Richard, explains how an inmate who has been five-pointed regains self control as his will to live begins to overcome his desire to die,” I said.
“How? What are you thinking?,” asked Richard.
“The will-to-live immunity, which has been temporarily weakened in a suicidal person, can be strengthened by inflicting privation, especially making a person uncomfortable or endangering his life,” I said. “One example would be depriving a person’s freedom. Being locked in a room with a suicide blanket with no clothes deprives a person of his freedom and makes him cold. Five-pointing does, too,” I said. “With privation, the will-to-live becomes strengthened, and when it becomes stronger, it will become safe to allow a suicidal person to regain control of his own safety.
“I think you’re brilliant, Richard,” I said.
“Not so fast,” said Benjamin. “There must be some holes in it somewhere.”
“Did Jerry return to your Unit?,” asked Richard.
“He did return a few days later, and we did not speak of suicide or why he had been taken to the hospital. He didn’t mention the five-pointing, and I didn’t ask about it. In fact, I never again spoke of suicide with him or anyone else,” I said.
Benjamin and Richard were quiet and thoughtful for a minute, then Richard spoke.
“Surviving the mental disease of suicide outside the prison in the community can depend upon knowledgeable people nearby who will act to prevent a suicidal act from occurring. A suicidal person must be in the right place at the right time. Furthermore, the people who respond must act to strengthen the natural will to live in a suicidal person. If they can’t do it themselves, then they must locate others who can and will.
“Many times,” said Richard, “this is purely a matter of luck.”
Discussion
- What do you think about Richard’s theory about suicide?
- What do you think about five-pointing?
Next |