Qualified Immunity Applies to Officials Who Do Not Have Subjective Knowledge of Inmate’s Suicide Risk
In Edmiston v. Borrego, 75 F.4th 551 (5th Cir. 2023), a plaintiff alleged that jail officials violated a pretrial detainee’s right to protection, under the Eighth and Fourteenth Amendments, from suicide. The defendant officials moved to dismiss the case on the basis of qualified immunity. The U.S. Court of Appeals for the Fifth Circuit held that although the detainee was not screened for suicide risk at the time of intake, the plaintiffs did not demonstrate that the officials had the requisite subjective knowledge of the detainee’s risk of suicide, and this subjective knowledge is necessary to demonstrate a failure to protect.
Facts of the Case
In Culberson County, Texas, on the night of July 6, 2019, decedent John Schubert called a jail official (Oscar Borrego) and said someone was trying to kill him (Schubert). That night, Mr. Schubert made similar statements to an off-duty trooper and to someone inside a hotel. The trooper and an individual at the hotel notified Mr. Borrego. Mr. Borrego instructed Sheriff’s Deputy Melendez to respond. Per the Deputy’s statement, when apprehended, Mr. Schubert “appeared nervous and said that people were trying to kill [him]” (Edmiston, p 555). Mr. Schubert did not provide his correct birth year. To identify him, Deputy Melendez brought Mr. Schubert to a Border Patrol Station. There the Deputy determined Mr. Schubert had a warrant for parole violation. Deputy Melendez arrested Mr. Schubert and brought him to the jail at 12:14 am on July 7. Mr. Schubert told Mr. Borrego and another official, Sheriff Carrillo, that he had left El Paso, had a history of drug abuse, and had left a halfway house in Horizon after “they were mean to him at the facility, and …he had had enough” (Edmiston, p 556).
The jail officials did not complete an intake mental health screening as specified by the Texas Commission on Jail Standards (TCJS). Mr. Schubert was not wearing a shirt and said this was because his shirt was wet. He was given correctional attire and placed in a cell at 1:42 am. He again told Deputy Melendez that “someone was trying to kill him” (Edmiston, p 556). Mr. Borrego gave Mr. Schubert a mattress. Suicide precautions were not initiated. At 1:48 am, Mr. Borrego asked another jail staff member (Ms. Zambra) to check Mr. Schubert’s driver’s license and criminal history. She did so. She also requested a report of his medical history, which returned as “no match.” At 2:42 am, she checked on the jail’s detainees. At Mr. Schubert’s cell, she observed him half-kneeling with a sheet around his neck. The other end of the sheet was tied to a shelf. He was nonresponsive. After being notified, Sheriff Carrillo arrived within minutes, began providing CPR, and instructed Ms. Zambra to call emergency services. Emergency personnel arrived at 2:59 am. Mr. Schubert was pulseless, not breathing, and was pronounced dead. His manner of death was listed as suicide caused by asphyxia from hanging.
The plaintiffs, administrator of Mr. Schubert’s estate and heirs, claimed Mr. Borrego, Sheriff Carillo, and Deputy Melendez violated Mr. Schubert’s Eighth and Fourteenth Amendment rights by failing to protect him from suicide. The defendants filed motions to dismiss based on qualified immunity. The district court denied the motions in 2022 and ruled that based on Mr. Schubert’s “fragile psychological state; his statements regarding an unidentified assailant; and [officials’] knowledge about the risk of jail suicides,” the defendants had the necessary subjective knowledge of an “obvious” risk of suicide or serious harm (Edmiston, p 557). The court stated that if an official has subjective knowledge of suicide risk and gives a detainee a ligature such as loose bedding, this act constitutes deliberate indifference and nullifies the official’s qualified immunity. The defendants appealed.
Ruling and Reasoning
Citing prior case law, the Fifth Circuit Court of Appeals stated that “pretrial detainees have a Fourteenth Amendment right to protection from a known risk of suicide” (Converse v. City of Kemah, 961 F.3d 771 (5th Cir. 2020), p 775). If an official is aware of facts (including circumstantial evidence) from which they infer substantial risk of a detainee’s suicide exists and fail to take actions to mitigate the risk, that would constitute deliberate indifference. But, the official is not liable if they “merely ‘should have known’ of a risk” (Converse, p 775). The court stated that officials are entitled to qualified immunity unless their conduct violates a “clearly established [statutory or] constitutional right” (Converse, p 774, and Mace v. City of Palestine, 333 F.3d 621 (5th Cir. 2003), p 623). To overcome qualified immunity, a plaintiff must demonstrate that “every reasonable official would have understood that what he is doing violates that right” (Est. of Bonilla v. Orange Cnty., 982 F.3d 298 (5th Cir. 2020, p 306, quoting Ashcroft v. Al-Kidd, 563 U.S. 731 (2011), p 741).
In Edmiston, the Fifth Circuit noted the plaintiffs’ allegations that the jail officials did not provide Mr. Schubert with a mental disabilities and suicide screening on admission as required by the Texas Commission on Jail Standards (TCJS) (37 Tex. Admin Code § 273.5 (2013)), and that there had been a prior suicide at the same jail. In response, the court stated, “there is no independent constitutional right to suicide screening” (Edmiston, p 560), citing the Supreme Court’s precedent that “no decision of this Court establishes a right to the proper implementation of adequate suicide prevention protocols” or “even discusses suicide screening or prevention protocols” (Taylor v. Barkes, 575 U.S. 822 (2015), p 826). According to the Fifth Circuit, even if the plaintiffs could assert a right to screening, deliberate indifference on the part of the officials would still require that they have subjective knowledge of Mr. Schubert’s suicide risk.
The court analyzed each defendant’s right to qualified immunity based on whether they had the requisite subjective knowledge. The court cited precedents explaining the standard for subjective knowledge based on evidence such as a witnessed suicide attempt (Cope v. Cogdill, 3 F.4th 198 (5th Cir. 2021)), hearing an individual make suicidal statements (Converse, p 776), or knowing that an individual had depression and that collateral information indicated the individual was suicidal (Hyatt v. Thomas, 843 F.3d 172 (5th Cir. 2016)). The court found that while Mr. Borrego, Sheriff Carrillo, and Deputy Melendez all knew Mr. Schubert had repeatedly expressed that someone was trying to kill him, there was no evidence he had behaved or spoken in a way indicating he was suicidal or at risk of self-harm. The court also concluded that knowing Mr. Schubert had a history of drug use and being in a halfway house would not have clearly led officials to infer that Mr. Schubert was at risk of suicide.
The court ruled the plaintiffs did not demonstrate the defendant officials had subjective knowledge that Mr. Schubert posed a substantial risk of suicide. The court held that the three officials were entitled to qualified immunity. Whether they responded with deliberate indifference was therefore not a concern. The lower court’s ruling was vacated, and the defendants’ motion to dismiss the failure-to-protect claims was granted.
Discussion
This decision is a reminder for forensic psychiatrists to understand the applicable standards in a specific jurisdiction (from both statute and case law) when asked to assess deliberate indifference by custody officials. Carceral facilities have a responsibility to ensure that detainees’ basic human needs are met. This includes making sure that detainees have access to adequate medical and mental health care. Unless appropriately assessed, detainees with mental disorders are at risk of these problems’ (including self-harm ideation) going undetected. The ruling in Edmiston utilized a “reasonable official” standard for determining whether a detainee’s suicide risk is elevated and requires a custody official to take mitigating action. The court reiterated that for claims of deliberate indifference in jail suicide prevention, the “reasonable official” standard is a subjective one.
The Fifth Circuit acknowledged that the TCJS specifies that inmates must have mental health and suicide prevention screening on admission. The court also noted that the TCJS had cited the jail (both before and after Mr. Schubert’s death) for violating requirements for intake screening and suicide prevention training. But, while the Fifth Circuit stated that the defense of qualified immunity is overcome if an inmate’s constitutional or statutory rights are violated, the court held there is not a constitutional right to suicide screening. Therefore, the court has distinguished between suicide prevention and other services that are constitutionally required in a carceral setting. Specifically, the Fifth Circuit appears to have determined that jail officials are not necessarily required to assess at intake whether or not an inmate has suicidal thoughts, plans, or intent.
This ruling could have substantial impacts on suicide screening as well as suicide prevention efforts in carceral settings. By emphasizing a subjective standard for deliberate indifference and discounting the guidelines set forth by the TCJS, the ruling creates a tension between efforts to improve suicide prevention strategies and officials’ interest in preserving the defense of qualified immunity. For instance, the Texas Administrative Code requires jails to provide training to staff regarding mental health and suicide prevention. Such training would position staff to better recognize inmates at risk of suicide and to intervene to reduce such risk. But, an official who participates in such training and does not follow the guidance could be at greater risk for claims of deliberate indifference. Moreover, one might argue that the knowledge gained from such training could limit one’s ability to employ a qualified immunity defense against such claims. Resolution of this tension to improve care in carceral settings will require collaboration between courts, clinicians, and regulatory bodies.
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