"Hanging Gestures" and IRFings

When is trying to hang yourself not an attempt at suicide? When you're a prisoner at Gitmo. Then it's just a "hanging gesture."

There have been hundreds of such "gestures" since Gitmo opened and only 39 official "suicide attempts."

Let's look at one incident  that involved a few of those silly "gestures":

TWENTY-THREE terror suspects tried to hang or strangle themselves at the US military prison in Guantanamo Bay in a mass protest in 2003, the military confirmed yesterday.

Officials would not say why they had not earlier reported the Cuba camp incident, which they categorised as “selfinjurious behaviour”, aimed at getting attention rather than committing suicide....

Guantanamo officials classified two of the incidents as attempted suicides and informed reporters. But they but did not previously release information about the mass hangings. They were mentioned casually during a visit this month [in 2005] by three journalists, but officials immediately denied that there had been a mass suicide attempt.

The military reported 350 "self-harm" incidents in 2003, including 120 "hanging gestures." In 2004, it reported 110 such incidents. And, go figure, it hasn't released any numbers for 2005 or for this year.

I spoke about all this to Marc Falkoff, a lawyer who represents a few detainees. He observed that the detainees who hung themselves last week were in cells where "there's nothing on the ceiling and the meshing is far too small to allow a sheet or anything to be tied to it. They would have had to slowly strangulate themselves by wrapping a sheet around the toilet bowl or something like that."

One other note, I was emailing with Marc a few weeks ago--before the suicides, and he mentioned what he saw the last time he visited Gitmo, in April:

One of our clients was a mess.  He'd been IRF'd [i.e. forcibly removed from his cell by an "Immediate Reaction Force"] a couple of days before and he was sickening to behold.  One eye was swollen shut, the other a deep black and blue.  Contusions all over his body, cuts on his head and legs.  He couldn't swallow and could barely talk. The "offense" meriting his forcible extraction was that he stepped over a line that they painted in his isolation cell.

Gitmo, unforuntately, has a history of such IRFings.

What we're seeing is what David Ingatius rightly calls "Guantanamo syndrome, [a] process of mutual corrosion and dehumanization." I've argued before that the U.S.'s problems with detainee treatment is larger than Gitmo. But closing the prison would be a start. As Ignatuis writes, "It's not just because of what it's doing to the prisoners but because of how it is dehumanizing the American captors."

UPDATE: I just spoke  with Gen.  Stephen Xenakis , a  former top military  medical  commander and Director of Child and Adolescent Psychiatry at the Psychiatric Institute of Washington. I asked him what "hanging gestures" means and whether it can be distinguished from a suicide attempt. His response, not surprisingly, was that it's  "not a meaningful term in terms of what we do clinically."

Xenakis also made another, crucial point. The dehumanization of detainees and playing  down prisoners' problems puts the U.S. itself and military and risk:

    I think they’re very worried about retaliatory acts after suicides—and rightly so. They’re very worried how the suicides are going to play out in the Arab world and elsewhere.  Their reference is Bobby Sands’ hunger strike and death in the early 1980s.

        So I find myself a bit puzzled by how this is being handled. If you’re looking to avoid suicides and a P.R. disaster, I think you’d act in the most dignified, humane way you can.  Keep detainees informed to the degree possible, make them feel comfortable, have some level of trust.  To do otherwise aggravates a sense of helplessness and despair. Detainees are going to think, “Who cares if we kill ourselves, we’re never going to get out of here.”

Comments

[Assistant Village Idiot]

So Dr. Xenakis says it's not a meaningful term in terms of what they do clinically? Dead wrong. And typical of the dead wrong for private psychiatric hospitals, BTW. Ask someone at the involuntary facility in your area - where Dr. Xenakis sends his people when his hospital "can't manage" them anymore, and you will get a different answer. My contempt for these guys probably seems unwarranted to you, but I've been doing public mental health for thirty years and I'm weary of people who people who pontificate when they don't take the more difficult patients. I also note that his comment about dehumanization is a political one, for which his professional credentials don't give him any advantage. (Psychiatrists do tend to see themselves as experts on political issues, though.)

There is definitely a difference between gestural suicide attempts, including hanging, and more serious attempts. There is a lot of gray area, but that doesn't mean that there aren't any differences. I suspect my clientel is more similar to the detainees than a private hospital's clients are.

I don't have any knowledge or opinion whether we're mistreating prisoners at Gitmo. If we are, we shouldn't, and people should be disciplined. But the information on the person IRF'd that you relate, is based entirely on one side of the story - the prisoner's, through his attorney. Why would that be the most credible source? (I know! I know! Because we believe rights attorneys and we don't believe the military!) I have seen false stories go to the newspapers - and to court - many times when rights attorneys decide that someone is being treated unfairly.

This is not to say that they aren't valuable, or even that they're usually wrong. They're usually right. But you just can't accept their information at face value.