Content warning: This article contains discussions of suicide, suicidal ideation and mental health challenges. If you or someone you know is struggling or in crisis and need someone to talk to, help is available. Call, text or live chat the Washington 988 Suicide & Crisis Lifeline. Support is free, confidential and available 24/7.
OLYMPIA—Growing up, Dr. Ashley Espitia’s dinner table conversations were different than most. Her father and several family members worked as traditional corrections officers in the California prison system. She would often hear stories of critical situations prison staff are called to respond to—contraband searches, breaking up fights and medical emergencies.
But what struck her most was hearing about the hours long suicide watches of incarcerated people in emotional distress. Instead of turning away from the darkness of those stories, a young Espitia found herself asking a question that would ultimately define her life’s work: “Who is helping those people?”
Today, Espitia is the answer to her own childhood question. As the suicide prevention specialist for the Washington State Department of Corrections, her mission is fundamentally different from generations before her. While her family’s legacy focused on making sure all the cell blocks were secure, Espitia’s legacy is helping to heal the mindsets of those who live within them.
One Side of Mortality: Lessons from Hospice
Espitia’s path to becoming a suicide prevention specialist in corrections was far from direct. Ironically, her early work focused on the opposite side of the spectrum: helping terminally ill patients accept death and find peace in their final days.
She developed a passion for working with older adults. Espitia grew up near a local nursing home and spent much of her free time in elementary and high school volunteering there—visiting with residents, sharing handwritten notes and dropping off baked treats around the holidays. With many residents lacking frequent visitors, Espitia found deep meaning in those simple interactions.
“It was just little things to let them know that they mattered and that they were loved,” Espitia said. “I quickly realized how much I loved listening to older people. They were so wise, and I could listen to their stories for hours.”
That early passion led her to hospice care counseling during her undergraduate studies. During one of her night shifts, Espitia visited a patient who doctors expected to pass away within a few days. The woman’s family lived out of state and couldn’t be there, leaving staff to conduct two-hour check-ins so she wouldn't be alone. Frightened and deteriorating, the patient kept expressing a deep fear of being left alone.
Espitia remembered a set of emergency glow sticks in her car. She retrieved them, cracked them open and placed the soft, warm light near the bedside to ease the woman's anxiety. When Espitia returned for her shift the next day, the woman had passed away—peacefully and surrounded by light.
“I was able to do something, even if it was small, to make someone feel not alone in their last moments,” Espitia said. “It really inspired me to work with this population more.”
Her work eventually brought her Coalinga State Hospital, where she provided end-of-life support to aging, terminally ill civilly committed men. Patients at this hospital were detained for treatment, typically after having already served long sentences for violent crimes. She remembers treating a widowed patient who was wheelchair-bound, going blind and said he had a deep burden of remorse. He told Espitia that his greatest regret was never being able to apologize to his family or the victims of his crime.
Recognizing his need for closure, Espitia guided him through a therapeutic exercise. She asked him to close his eyes, picture the people he had hurt, and speak the words of apology and regret he had carried for years.
“He truly wanted to be a better person and die knowing he had done everything he could to make amends,” Espitia said.
The Other Side of Mortality: Saving Lives Through Suicide Prevention
Sitting at the bedsides of terminally ill patients sparked a transformative realization for Espitia. With hospice patients, the clinical goal is helping people find acceptance and peace with something inevitable. However, suicide prevention offers a chance to alter a life’s trajectory entirely. It presents an opportunity to work through a crisis before it becomes fatal.
Espitia saw the chance to spread that philosophy in Washington state. She relocated in 2023, first working as a psychologist at the McNeil Island Special Commitment Center and then joined the Department of Corrections in 2024 as a suicide prevention specialist.
For Espitia, suicide prevention isn't just about crisis intervention; it’s about fundamentally shifting a person's mindset to help them see a reason to keep living. She often encounters a common societal attitude that questions why resources should go toward the mental health of people who have committed crimes. To explain her approach, she uses a simple, powerful analogy.
"Imagine a child playing soccer inside the house. Good parenting isn't just standing there yelling 'don't do that,'” Espitia explains. "Good parenting is taking the ball, opening the back door, and showing them where they can play instead."
In her eyes, many incarcerated individuals have spent their entire lives being told "no" and "don't," without ever being given alternative tools or shown a path forward. While a hospice patient cannot choose to live, an incarcerated individual in crisis can—if someone takes the time to open that symbolic back door.
Opening the Door to Innovation
Espitia has been opening that back door in many ways.
Suicides remain one of the leading causes of unexpected deaths in correctional facilities – highlighting the need for accessible, immediate support.
One accomplishment Espitia is particularly proud of during her tenure at the Washington State Department of Corrections is working with the Department of Health, DOH, to bring the 988 Suicide & Crisis Lifeline into prisons. Washington is the first state in the nation to do so.
When someone calls 988 from a prison, they are connected to professional counselors from DOH who are trained to provide support to help prevent a situation from becoming an emergency.
Since launching in late 2025, the 988 Lifeline has received hundreds of calls from incarcerated people seeking help with all sorts of challenges that have the potential to become life-threatening scenarios – like coping with substance use urges, maintaining mental wellness through stress management and having trouble handling difficult emotions.
Earlier this year, Lifeline counselors answered a call from an incarcerated individual intent on ending their own life. The coordinated response that followed allowed staff to intervene in time.
“Every call matters, and this particular instance involved a level of urgency where coordinated response helped prevent a potential loss of life,” Espitia said. “It shows our hard work has proved itself, and we’re really proud of it.”
Another way Espitia is addressing the elevated risk of suicide in correctional facilities is through people-centered solutions. One of her key initiatives involves going straight to the source: listening to the lived experiences of incarcerated individuals—specifically those who have personally struggled with suicidal ideation, survived a suicide attempt or experienced having a cellmate in crisis. She is currently using these insights from incarcerated individuals to develop a peer-led suicide prevention training manual for incarcerated individuals. It provides real-world guidance for facility residents including how to recognize behavioral shifts in a cellmate and knowing how to reach out to individuals or safely alert staff—turning those inside facilities into another compassionate first line of defense.
She also partnered with the DOC’s communications team to produce a suicide prevention video for newly-incarcerated individuals. It features candid stories from incarcerated individuals about their own struggles with crisis, coping with suicidal ideation, and the impact felt from seeing peers go through dark moments.
“It’s peer mentorship in a way,” Espitia said. “Why don’t we ask the people who we are trying to help for help?”
A Regular Part of Improving Public Safety
Beyond peer initiatives and program improvements, Espitia works behind the scenes, reviewing past mortality reports and critical incidents to remove physical environmental hazards. For example, she helped introduce specialized tear resistant bed covers into facilities to make it more difficult to create ligatures. She also makes sure staff are equipped with proper safety tools and knowledge of how to use them to rescue people in emergency situations without causing additional bodily harm. She also facilitates annual suicide prevention training for custody staff working in prisons and reentry centers across the state on how to spot warning signs and familiarize themselves with proper protocols on to act quickly when a life is on the line.
A lot of the daily tasks Espitia does as a suicide prevention specialist deal with heavy subjects that aren’t for the light-of-heart. But Espitia says no matter how dark her work can seem, saving a life is worth it.
“Death is not the way out,” Espitia says. “Suicide is a forever solution to a temporary problem. Life can get better. Whatever circumstances there are or whatever is going on in your life, individuals have a choice. Helping them to make a choice that is in the direction of living is meaningful. Why not choose to live?”
