The number of people dying by suicide while locked inside North Carolina prisons is at a historic high so far this year.
Since Jan. 1, nine inmates have ended their lives in the prisons, an average of one a month, according to the state Department of Public Safety. Only once in the past 30 years - in 2018 - have North Carolina prisoners committed suicide so frequently.
By another measure - the percentage of inmates who die by suicide - 2022 is shaping up to be even worse than 2018.
Inmate advocates are alarmed. They suspect severe staff shortages inside the prisons are largely to blame. In August, about 40% of correctional officer positions were vacant, according to the state Department of Public Safety.
As officers struggle to keep order in many short-staffed prisons, they have required prisoners to spend long periods alone in their cells, the advocates say. Research has found that such solitary confinement can cause and worsen mental illness.
On top of that, advocates say, the staff shortages mean that many inmates have less access to mental health treatment - and that prison officers can't check on inmates as frequently as they used to.
"This is an alarm," said Susan Pollitt, a senior attorney for the nonprofit Disability Rights North Carolina. "It's got to be a wake-up call."
Prison officials take many steps to prevent inmates from harming themselves, state Department of Public Safety spokesman John Bull said. They work to identify inmates who are experiencing mental health problems and provide them treatment, he said. They also place more than 2,000 inmates a year on suicide watch.
"The department takes this issue seriously and our mental health, medical and security staff take extensive efforts to assist offenders with mental health and self-harm issues," Bull said in a written statement.
'He needed help'
The latest victim - 29-year-old Didier J. Carias, Jr. - had long suffered from schizophrenia and paranoia, his parents say.
They say he recently was getting treatment for those problems at a hospital when he punched a man there. As a result of that probation violation, he was sent to prison.
Soon after entering Piedmont Correctional Institution in Salisbury on Aug. 25, he hit an officer and was immediately put in solitary confinement, his parents say. While there, he couldn't visit with his family - or even talk with them by phone, they say.
His time in solitary confinement only made his mental health problems worse, his parents suspect.
On Sept. 26, just 32 days after he'd entered the prison, he was found hanging by a sheet tied to a sprinkler head, his parents say.
Now his parents question why a person with such severe psychological problems was placed in solitary confinement.
"Being alone for 30 days is a long time," his mother, Judy Carias, told the Charlotte Observer. "Even a normal person would go crazy. … Why did they put him in solitary? He needed help."
His father, Didier Carias Sr., said he has learned that other inmates at Piedmont Correctional have also committed suicide in the same way in recent years. The Observer has confirmed that at least five other inmates at that prison have killed themselves since 2008, and that at least three of them died by hanging.
"We want to know why they haven't done anything about it," Carias' father said.
State prison officials declined to discuss the cases of those who died.
'A state of despair and depression'
County jails recently saw a spike in suicides, too. At least 21 people in North Carolina jails took their own lives in 2020, a record number, according to a Disability Rights North Carolina report released this year.
All but two of the suicides in state prisons this year happened inside maximum security facilities, where inmates are housed in single cells instead of dormitories. In August, the correctional officer vacancy rates in those prisons ranged from 16% to 62%.
At least four of the inmates who committed suicide this year were in "restrictive housing," the prison system's term for solitary confinement, state records show.
About 2,500 of North Carolina's 30,000 prison inmates are currently in solitary confinement.
But those officially in solitary confinement aren't the only state prison inmates forced to cope with extreme isolation in recent years. During the most dangerous portion of the pandemic, before vaccines became widely available, many inmates in maximum security prisons were confined to their cells almost all day as the prisons worked to limit the spread of COVID-19.
Since then, advocates say, officers in some short-staffed prisons have continued to lock down many inmates for 22 or more hours each day, even if they have not technically been placed in solitary. Those conditions have taken a toll on inmates, advocates say.
"I think there's a sense of helplessness," said Sandra Hardee, executive director of NC CURE, an inmate advocacy group. "We've moved into a very volatile situation."
Kerwin Pittman, policy and program director for Emancipate NC, a Durham-based civil rights group, says he hears regularly from men and women locked up in state prisons who say they are suffering the effects of extreme isolation.
"It just leads to a state of despair and depression," he said. "It forces them to stew with the reality that they are in a cage."
Pittman has seen firsthand what can happen to inmates in such circumstances. During an 11-year stay in state prison, he said he spent nearly 1,000 days in solitary confinement. Although he kept himself sane with the help of many books, he said others in "the hole" weren't so fortunate.
"I've seen a lot of people lose sight of reality and go crazy back there," he said.
Didier Carias' parents wonder whether prison had that effect on their son, too.
When he was taking medication for his psychiatric problems, he was a happy young man who loved to go to church, listen to hip hop music, and spend time with his brother and 6-year-old nephew, his parents said.
But when he was off his medications, he could be an entirely different person. He heard voices, his mother said, and often felt people were out to get him.
Whether he'd been getting his medication in the weeks before he died is unclear, his parents said.
"There has to be something coming out of this," his mother said. "We want justice. We want no other people to go through what we are going through now."
Some of the inmates who reportedly took their own lives in the state prisons this year had documented mental health problems.
Among them was Marcus Robinson. In 2012, Robinson became the first North Carolina prisoner to have his sentence reduced under the state's Racial Justice Act. He had been on death row, but a judge in the racial justice trial re-sentenced him to life without parole after finding that prosecutors had intentionally removed Black citizens from the jury that convicted him of murder in 1994..
While in prison, Robinson, 49, was classified as "Mental Health Grade 3," the most severe psychiatric classification, due to depression and schizophrenia, according to a medical examiner's report.
In early June, inmates at Scotland Correctional Institution, in Laurinburg, noticed that he had not been eating and had not been "socially active" on his cell block, according to the report.
On June 9, he was found hanging in his cell.
Elizabeth Simpson, an attorney for Emancipate NC, is investigating Robinson's death. She said she has heard from multiple inmates that prisons are so short-staffed that officers frequently skip their required checks on inmates.
As a result, she said, officers likely miss seeing when some prisoners are gripped by mental health crises. With more officers and more checks, she said, more inmates who are preparing to commit suicide might be caught.
"The conditions in which (Robinson) died are conditions that others are living in," Simpson said. "And they're very unbearable conditions."
Bull the prison spokesman, disputed allegations that officers have skipped checks. "Correctional Officers make their rounds, as required," he wrote.
After a spate of inmate suicides in 2016, state prison officials put in place a plan to prevent more inmates from taking their own lives.
Among other things, the plan required that the prisons train staff members to recognize when inmates are at risk of killing themselves. It also said prisons should try to keep inmates with mental illness out of solitary confinement, a punishment that can worsen psychiatric problems.
In 2017, Bull said, suicide prevention training was offered to all of the prison system's licensed behavioral health staff. And in 2018, prison officials created a suicide prevention work group to evaluate all aspects of suicide prevention.
"Prisons staff are dedicated to identifying offenders with mental health issues, particularly those at risk for self-harm, through comprehensive risk assessment and the implementation of a suicide watch protocol for individuals determined to be at-risk," Bull wrote.
But advocates say that given the severe staff shortages, the recent deaths highlight the need to further reduce the population of the state's prisons. Among those who they say should be released: elderly and disabled inmates who pose no threat to the community.
Said Dawn Blagrove, executive director of Emancipate NC: "They simply can't safely and securely keep as many people in cages as they are now."