Conducting the Psychological Autopsy in Correctional Settings

Abstract

The demand characteristics associated with the unique population and environment of the correctional setting dictate a distinctive approach to conducting the psychological autopsy. A review of the professional literature indicated there were no comprehensive guidelines or report formats developed for constructing the psychological autopsy in prison settings. This article proposes specific guidelines, content designations, and a structured report format to standardize the methodology for conducting the psychological autopsy. It also provides an overview of the evolution of the psychological autopsy as an investigative and forensic technique. Practical applications of the psychological autopsy in correctional settings are discussed within the context of clinical risk management programs. A conceptual model for evaluating the impact of identified risk factors on the decedent's decision-making process is proposed.

Suicide Prevention in Correctional Settings

“…We echo many prior efforts in the area of prevention practices reviewed here (e.g., Aufdefheide, 2000; Hayes, 2013; NCCHC, 2008); specifically, we agree that best suicide prevention practices should include all of the following: (1) ongoing, continuous suicide risk assessment for all inmates; (2) adoption of crisis response planning over ineffective means of crisis intervention (e.g., no suicide contracts, extremely isolated environments); (3) fostering healthy, positive interactions for inmates with staff and mental health providers; (4) required annual training for all correctional and mental health staff who interface with inmates; and (5) psychological autopsy in cases of completed suicide in order to identify factors contributing to suicide that can be incorporated in future research and prevention efforts. However, these generalizations are insufficient, as security staff and management may lack the requisite mental health domain expertise to move forward.…”

“…Several professional organizations (i.e., ACA, American Psychiatric Association, and NCCHC; see NIC, 2010, for review) and expert commentaries (i.e., Aufderheide, 2000; Fagan et al, 2010; Hayes, 2013; Magaletta & McLearen, 2015; Sanchez, 2013) offer best practice considerations. Table 2 summarizes the recommendations, some of which are supported by multiple sources.…”

“… Note . This lists represents a composite of recommendations from several sources (i.e., American Psychiatric Association, 2000; Aufderheide, 2000; Fagan et al, 2010; Hayes, 2013; Magaletta & McLearen, 2015; National Institute of Corrections, 2010; National Commission on Correctional Health Care, 2008; Sanchez, 2013), many of which are consistent across sources. …”

“…Existing correctional suicide prevention strategies consistently highlight the need for training, going so far as to suggesting frequency and some general content for the training (e.g., NCCHC, 2008). A unique area for such training may be seen in psychological autopsy (American Association of Suicidology, n.d.; Aufderheide, 2000). Such recommendations fit the general mission of these organizations by providing general guidance; a solid foundation, however, is lacking in empirical grounding and necessary detail.…”

Self-Injurious Behavior in Correctional Settings

“…In correctional settings, the psychological autopsy has become a valuable investigative technique for understanding and improving the management and prevention of self-injurious behavior that results in a suicide (Toch, 1992). As a risk management document, it can provide an opportunity to review and evaluate the efficacy of the mental health care delivery system, specifically the self-injury prevention component; aid in the identification of specific training needs for health/mental health care and security staff; and provide an opportunity for the identification of program strengths and weaknesses related to the management of self-injurious behaviors (Aufderheide, 2000). The psychological autopsy, therefore, can be a useful tool for correctional managers to educate their staff on evidence-based practices to reduce the potential risk of suicidal and self-injurious behaviors.…”