Following a rash of suicides at the D.C. jail, almost every one of the nearly 1,400 inmates now shares a cell, under the thinking that it is harder to kill yourself with someone nearby.

With every pill and safety razor banned, inmates line up for shaves twice a week from a visiting barber, and a single Advil requires a visit to a jail nurse.

And each time a new inmate comes in, wardens rush to get records to psychiatrists and social workers tasked with deciding whether someone poses a suicide risk. Each of the four inmates who killed themselves in the past year had been accused of sex crimes — a red flag, but the health workers who first assessed them didn’t have immediate access to court records.

Those steps, in many ways, have been the easy ones for D.C. corrections officials as they try to halt an unprecedented wave of in-custody deaths.

The next step, jail officials acknowledged in a hearing late last week, will be more complicated. The jail must change a “culture” among officers and health workers that has held that most suicide attempts inside the Capitol Hill complex are efforts by inmates to get attention, such as a night in a hospital room with dinner and a television.

According to a report released late last week, that’s the wrong diagnosis for many of the 165 suicide attempts logged inside the D.C. jail in the past two years.

Every one of the roughly 12,000 inmates who rotate through the jail annually should be held in suicide-resistant cells, the report said. Roughly 40 percent of the inmates suffer from mental health conditions, and of that group, scores if not hundreds would benefit from prolonged psychiatric care while in custody, the report concluded.

“By default,” said D.C. Corrections Director Thomas Faust, “we are the city’s largest mental health institution.”

Built in 1976, when the city still kept many of its mentally ill in now-shuttered psychiatric hospitals, the D.C. jail is also a facility “not built for that,” Faust added.

Most immediately, Faust said, Mayor Vincent C. Gray (D) has committed $600,000 to begin retrofitting aging cells to remove welded towel bars and clothes hooks installed decades ago.

The jail next year will also begin work to place fine mesh over the large air-conditioner grates on most cell ceilings and to modify mattress frames to eliminate obvious ways to fashion a noose. Three of the four who committed suicide in the jail in the past 12 months hanged themselves inside their cells.

Council member Tommy Wells (D-Ward 6), who is running for mayor, said a much bigger expense may be needed. He renewed a call Thursday to replace the aging jail entirely. He suggested cost savings from a more efficient building might be able to help offset the cost of additional mental health programs.

“The jail needs to go,” he said. “We need a facility that can keep people safe.”

Outside of the physical changes, jail officials said they are making additional policy changes. For instance, when a family member or attorney warns that a jailhouse visit or sentencing could bring bad news, supervisors now automatically send inmates for follow-up mental health evaluations.

Lindsay M. Hayes, a nationally known expert on suicide prevention in jails, spent three days assessing D.C.’s jail at Faust’s request. In one of the reports released last week, Hayes said the city must end a seemingly punitive way of dealing with many of those who attempt suicide.

They are placed in isolation for days, often with only a paper gown, but sometime naked. The treatment is ostensibly a way to protect inmates from themselves, but Hayes said the jail shows little regard for their safety by only checking on them in 60-minute intervals.

Hayes said the city also needs to invest more resources in constant monitoring of those on suicide watch, and checking in on those with elevated risk at least every 10 minutes, instead of the current interval of 15 minutes.

Scores and perhaps hundreds of other inmates should be in a “step-down” mental health ward inside the D.C. jail where they could attend group therapy and behavioral modification, Hayes said.

A task force established by the jail will study that idea this month, but by one estimate, it could require nearly 30 additional officers and untold health-care resources.