“If You Kill Yourself, I Will Kill You!”
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During graduate school, I worked as a forensic psychologist in one of the most dangerous county jails in the country. It was crowded, noisy and short-staffed. Often, I had to make suicide assessments in only 1 minute through a jail-cell door’s pothole. Putting an inmate on suicide watch was not a decision I made lightly because it meant that the prisoner would be checked upon (and if asleep, woken up) about every 15-30 minutes. This level of sleep interruption can cause someone to become suicidal, even if he/she had not been suicidal prior to being placed on the suicide watch list.
After I realized that I didn’t have 30 minutes to conduct a thorough suicide assessment, nor could I sit with them face to face in a private office, I developed a 20-30 second interview to determine whether an inmate should be placed on suicide watch. This included 3 questions: 1. What is your name? 2. Why are you in jail? and 3. Are you suicidal? If the person clearly stated they were suicidal I placed them on suicide watch.
However, if the person stated that he/she was not suicidal, but I doubted whether they were coherent, oriented, or truthful, I would say, “I will not put you on suicide watch, but if you kill yourself, I will kill you!” I would then wait to observe their response. If they realized how crazy the statement was and told their roommate something like “The doctor is crazy,” I was more likely not to put them on suicide watch. However, if they responded back to me with “Doctor, you cannot do that to me,” I knew that their judgment was probably impaired and I placed them on suicide watch.