John gets into a heated argument with his live-in girlfriend after losing his third job in two months. Angry and slightly intoxicated, John jumps into his car and takes off, only to get pulled over by a sheriff’s deputy.

Caught drinking while driving, John is taken into custody and booked into the county jail. During the booking process, John displays very erratic behavior - he’s hostile to the officers one minute, conciliatory the next and later begins sobbing uncontrollably. When it’s time to take him back to the holding cell, John becomes physically violent and screams and the officers have to physically push him into the cell.

Several minutes later one of the officers notices that the screams coming from the holding area have stopped. The officer goes back to check on the prisoner, but it’s too late. John has hung himself with his own shirt from one of the cell bars.

The scenario described above was a fictional tale used in a training video, but a real life situation could occur in any county jail at any time. In an effort to prevent suicides in county jails and reduce the liability risk for counties, about 800 jail staff and sheriffs across the state attended a spring law enforcement regional workshop on suicide detection and prevention in jails.

Developed by the Texas Commission on Law Enforcement and Officer Standards and sponsored by the Texas Association of Counties, the purpose of the workshops was to provide county corrections officers with an understanding of offenders with mental impairments, suicidal behavior and methods for detection and prevention of suicide.

According to national statistics, suicide is the leading cause of death in U.S. jails. The suicide rate in county jails is nine times greater than the general population.

Carmella Jones, law enforcement specialist for TAC and a former sheriff, said suicides could often lead to costly lawsuits against counties and she reviewed several lawsuits filed against counties because of incidences in the jails.

Jail suicide litigation typically centers around certain factors: insufficient staff, inadequate training and supervision, deficient jail conditions, lack of policies and procedures for screening and monitoring potentially suicidal inmates and overcrowding.

Jones said in many cases the plaintiffs must prove deliberate indifference, or that there was a strong likelihood that someone’s failure to provide care would result in harm to the prisoner.

Guest speaker Lt. Kelly Rowe, administrative lieutenant over the detention division for the Lubbock County sheriff’s office, said most jail suicides could be averted with implementation of a comprehensive prevention program. A prevention program should include proper staff training, intake screening, communication between staff, appropriate and safe housing, frequent observation, prompt intervention and human interaction between staff and inmates.

Although there are "suicide victim" profiles that officers should be familiar with, an inmate’s emotional state and behavior at booking is the most significant indicator of whether that individual might be a suicide risk, Rowe said.

The course educated jailers about a number of signs or symptoms that might indicate a person is suicidal, including depression, expressions of guilt or shame, suicide threats, use of drugs or alcohol, severe agitation, feelings of hopelessness and noticeable behavior changes.

A mental health condition, such as bi-polar disorder or schizophrenia, can be a significant predisposing factor in jail suicides, Rowe said. Jailers should be able to recognize the signs of mental illness or mental retardation in order to refer those individuals to mental health services or crisis intervention.

Rowe stressed that it was imperative for county officials to have a good working relationship with local mental health service providers, such as Mental Health/Mental Retardation clinics, in order to divert mentally ill from the jails.

The Texas Commission on Jail Standards requires jailers to conduct a mental disability/suicide intake screening on all inmates, identifying medical, mental health or other special needs and to make appropriate referrals to mental health services.

"(Booking) is the most important part of the whole process," Rowe said. "You need to take the time and slow down to ask the right questions and be prepared to follow up depending on the inmate’s response."

During the booking process, officers should carefully observe the person’s behavior, speech, actions and attitude. Officers should also be on the lookout for scars from previous suicide attempts, trauma or bruises or any visible signs of drug or alcohol use and determine if the individual is using any kind of medication.

Rowe said monitoring procedures, or how closely an inmate was watched, is one area in particular that raises a flag in liability claims. Jail staff should avoid detaining inmates at risk of suicide in isolated areas. Inmates classified as low risk for suicide should be placed under close watch and physically observed every 15 minutes. Those identified as high risk should be placed under constant watch.

Speakers at the workshop also recommended housing at-risk inmates in suicide-resistant cells located in high traffic areas. Any dangerous clothing, such as belts, ties, shoelaces or suspenders, should be removed. Audio monitoring or closed circuit TV should not be used as a replacement for staff observation, Rowe said.

In the event that a suicide does occur, Rowe said it was imperative for the first officers on the scene to start life-saving measures immediately and to continue until medical help arrived. Only medical personnel or a justice of the peace can pronounce someone dead, he said.

After the incident, officials should conduct an administrative review that includes a critical review of the circumstances involving the incident, review of jail procedures and a synopsis of relevant training received by staff.