This essay contains discussions of suicide and self-harm. It was published in partnership with Solitary Watch, a national nonprofit newsroom whose mission is to uncover the truth about solitary confinement and other harsh prison conditions in the United States.
Lynne (a pseudonym) jolts awake at 2 a.m. to a corrections officer banging on her cell door, and she already knows what is coming next. After serving 15 years of a life sentence, Lynne has learned to recognize the sound of emergency in this place. Tonight, like so many nights before, she will be escorted to the segregation unit to perform what prison administrators euphemistically call "Continuous Direct Observation." She will sit in a metal chair outside a bare cell and watch another human being contemplate ending their life.
The Texas women's prison where Lynne is incarcerated calls her a "life coach," a title that suggests training, credentials, and choice. The reality is far different. Lynne is performing the fundamental duty of correctional officers while those same officers sit in climate-controlled control centers, eating their meals, and scrolling through their phones.
The life coach program was introduced with fanfare as a peer-led initiative designed to offer incarcerated people someone to talk to, a compassionate ear during difficult times. Lynne underwent two months of training that covered basic listening skills and crisis de-escalation techniques. What the training never prepared her for was the grinding reality of 8 to ten-hour-long shifts spent watching someone stripped of everything but a suicide-resistant gown, denied even the dignity of toilet paper unless they beg for it.
Six squares at a time. That is what Lynne is instructed to dispense when the person she is watching needs to use the toilet. She must stand at the cell door and pass the paper through the metal mesh, then watch to ensure it is used only for its intended purpose. During menstruation, the dehumanization deepens. Lynne must exchange clean menstrual pads or tampons for used ones, handling another woman's blood and shame because the correctional staff has determined that even basic hygiene supplies could become weapons in the hands of the suicidal. She bears witness to the particular cruelty of biology continuing its cycles even as a person's will to live ebbs away.
The chair where Lynne sits is both her watchtower and her cage. From this vantage point, she must observe every movement, every gesture, every sign that the person before her might attempt to harm themselves. If the woman begins banging her head against the concrete wall, Lynne must immediately notify staff. If a razor blade appears from some impossible hiding place and skin begins to split and bleed, Lynne must sound the alarm. But the guards who are paid to do this work remain behind thick glass, their attention divided between gossip and cold coffee.
The women Lynne watches often use their time to unburden themselves of their trauma, as if Lynne's presence offers absolution or understanding. They pour out stories of childhood sexual abuse, domestic violence, addiction, and the cascading failures that led them to this cell. They articulate with devastating clarity why they believe the world would be better without them. They are trying to convince Lynne of their worthlessness, to make her complicit in their despair. Each story adds another layer to the weight Lynne already carries.
This phenomenon has a name in psychological literature: secondary trauma, also called vicarious trauma or compassion fatigue. It occurs when someone is repeatedly exposed to the traumatic experiences of others, absorbing their pain until it becomes indistinguishable from their own. Therapists who treat trauma survivors can develop PTSD symptoms themselves. Emergency responders who witness tragedy after tragedy find their mental health deteriorating. The difference is that those professionals receive supervision, mandatory counseling, and the option to step away. Lynne receives none of these protections.
Secondary trauma manifests in nightmares, hypervigilance, emotional numbing, and intrusive thoughts. It rewires the brain's threat detection systems and floods the body with stress hormones that have nowhere to go. For Lynne, already navigating the daily trauma of imprisonment and a life sentence that stretches endlessly before her, this additional burden could prove catastrophic. She cannot leave her shift early because the memories become too heavy. She cannot request a transfer to a different unit. She is locked into this role by the same bars that confine her to this institution.
What Lynne sees during these shifts would break most people. The segregation unit houses those whom isolation has pushed past the edge of sanity. Some women paint their bodies with their own feces, creating grotesque murals on skin and walls. The smell becomes part of Lynne's clothes, her hair, her memory. She watches women scream at voices only they can hear, carrying on arguments with invisible tormentors. She sees self-mutilation in forms that defy comprehension: Women who have swallowed razors, chewed through their own flesh, or found ways to injure themselves that speak to both creativity and desperation.
The cruelty is not limited to what isolation does to the human mind. Lynne also witnesses how staff weaponize their power. She has seen officers refuse to deliver meal trays to women who declined their sexual advances, using starvation as punishment for refusing to be assaulted. She watches this corruption unfold in real time, powerless to intervene, knowing that reporting such abuses often leads to retaliation against those who speak up.
Sometimes the women Lynne is watching throw feces or urine at her through the metal mesh in the door. In their degradation and rage, she becomes another target, another representative of the system crushing them. Lynne understands this intellectually, but understanding does not make the humiliation easier to bear. She washes the filth from her skin and hair in a communal shower, then returns to her cell where the smell lingers in her nostrils and the memory replays behind her closed eyes.
Lynne does this work without compensation. She receives no sentence reduction, no credits toward parole consideration. The prison extracts her labor and her psychological well-being while offering nothing in return except the brittle satisfaction of knowing she may have kept someone alive for one more shift.
When I ask Lynne why she continues, her answer is simple and gutting: "I would want someone to do this for my child."
In the free world, robust systems exist to support people in crisis. When someone expresses suicidal thoughts, they can call various suicide hotlines and speak to trained counselors. They can go to emergency rooms where psychiatric professionals will assess them. They can access therapists, crisis intervention teams, and psychiatric medications. The people who work in these roles have extensive training, clinical supervision, and mental health support for themselves.
Inside these walls, we have none of that. No suicide hotline. No 24-hour crisis counselors. No psychiatric emergency services beyond whatever the prison's part-time psychiatrist can manage. What we have instead are 20-year-old correctional officers, often male, who view mental health emergencies as annoying disruptions to their shifts. Lynne finds herself having to convince these guards to call for medical help, to take seriously the desperation of the women she is watching. Some listen. Others roll their eyes and return to their phones.
Putting at-risk people on suicide watch in prisons and jails is not limited to Texas, nor is assigning other incarcerated people to be the watchers. While research on the practice is scant, one 2024 study found at least 18 states and the Federal Bureau of Prisons with jurisdiction-wide policies for "Peer Comparison Programs for Those on Suicide Watch" what are variously called "suicide watch companions," "suicide prevention aides," or "inmate watchers." The study notes that these incarcerated workers receive varying degrees of training and compensation—but no mention is made of any services to help them deal with the trauma produced by their jobs.
For Lynne, the worst of this trauma comes with the women who haunt her sleep. The women who didn't make it. The ones who found a way despite the gown, despite the observation, despite Lynne's vigilance. Their faces join the gallery of ghosts that every incarcerated person carries. For Lynne, who was there in their final hours, who heard their last words and witnessed their last acts, the haunting cuts deeper. She carries the irrational but inescapable guilt of the survivor, the watcher, the one who was supposed to prevent the inevitable.
The question everyone seems to ask is why Lynne has been given this responsibility. Why is an incarcerated woman with her own trauma and a life sentence being forced to perform crisis intervention without training, without support, without even basic compensation? The question reveals our willingness to exploit the vulnerable while calling it peer support.
But there is a bigger question that no one in authority seems willing to address: Why are we putting people in solitary confinement when decades of research confirm that isolation causes the very suicidal ideation we then scramble to prevent? We create the crisis, then deputize the traumatized to manage it. We know that solitary confinement destroys mental health, yet we continue to use it. We know that putting already-traumatized women on suicide watch causes secondary trauma, yet we continue to require it. The cruelty is not incidental. It is structural.
Lynne sits in her chair through another long night, watching another woman unravel, bearing witness to suffering she has no power to end. This is the work we have assigned her. This is the price we have decided she must pay for the possibility of redemption, for the chance to prove her humanity in a system designed to deny it.
And tomorrow night, or the night after, they will bang on her door again.