When “Suicide Watch” Becomes a Death Sentence

Support for this article was provided by the Alicia Patterson Foundation. When Anthony Gay was…

When “Suicide Watch” Becomes a Death Sentence

When Anthony Gay was booked into the Peoria County jail in Illinois in 2022, after a conviction for “possession of a firearm by a felon,” he was placed in a so-called rubber cell, a freezing solitary confinement space with a hole in the floor for a toilet. Being left alone in these conditions triggered feelings of abandonment, a result of his borderline personality disorder and the PTSD he suffers from spending decades in solitary confinement during a previous incarceration.

“It made me more agitated, more upset, feeling more rejected,” he recalled. “And I ended up stabbing a pencil into my arm.” After multiple incidents of self-harm, Gay was placed on suicide watch, where he remained for 40 days.

On suicide watch, he said, “they kept me in a holding cell where the light was on 24 hours…. It was freezing in there.” An officer positioned in an open doorway was supposed to make sure he didn’t harm himself, but was often distracted and not paying close attention. “I cut [myself] like five or six times.” In one incident, Gay cut open his scrotum, which he said saturated the cell with blood. He said officers cuffed him, kicked him, and put him in a painful restraint chair and a spit hood for three hours before he was able to see a mental health clinician and then taken to a hospital.

Gay was later transferred to a federal prison in Butner, N.C., to undergo a mental health assessment and treatment. There, too, he was placed on suicide watch multiple times, including once for 40 days, during which he said he was not allowed to shower or brush his teeth. “I smelled so bad it caused me nausea,” he recalled. He said incarcerated people, not staff members, were assigned to watch him at times, and security staff had the power to put him in restraints without the consultation of mental health staff. He continued to harm himself and said he was admitted to the hospital five or six times.

In both the county jail and the federal prison, the suicide watch conditions reminded Gay of the 22 years he spent in solitary confinement in Illinois prisons after an initial arrest for stealing a hat and a dollar bill in a 1994 altercation. In prison, Gay’s mental health deteriorated, he racked up punishments, and his prison sentence—and time in solitary—snowballed. (He was finally released in 2018 but was rearrested in 2020 for possession of a weapon, which he maintains was planted.)

Jails and prisons typically place people considered to be at risk of suicide or self-harm on suicide watch. In federal prisons like the one Gay went to, people can be kept on watch for as long as staff determine them to be suicidal. Federal courts have ruled that in mental health detention units, ​​”treatment must entail more than segregation and close supervision of the inmate patients.”