Abstract
In the present study, we examined the effects of implementing the suicide risk screening instrument SIRAS in a pre-trial detention facility for men in Berlin. Within a period of 3 months, all newly arriving prisoners were screened (n = 611) by social workers or prison officers. Cases of elevated suicide risk were immediately referred to a psychologist or medical staff the same day. Follow-up over a 6-month period showed that 14% of all incoming prisoners were classified as high-risk individuals. These individuals received significantly more psychological and psychiatric treatment and were significantly more likely to be accommodated in crisis intervention rooms and emergency community accommodation (shared prison cells). In addition, it was found that despite the increased amount of treatment in the high-risk group, the number of specific measures did not increase significantly compared to the pre-implementation phase (N = 1,510).
Highlights
Prevalence of psychiatric disorders among prisoners is many times higher and suicide is one of the leading causes of death in prison [1,2,3,4]
The exact rate of suicide varies widely according to the study design, with values most frequently reported at 2- to 10-times higher rate compared to the general population [5, 6]
Statistics can be distorted as well by varying definitions of suicide; some studies include the overdose of drugs or are unable to include suicidal intentions covered as traffic or household accidents [9]
Summary
Prevalence of psychiatric disorders among prisoners is many times higher and suicide is one of the leading causes of death in prison [1,2,3,4]. The exact rate of suicide varies widely according to the study design, with values most frequently reported at 2- to 10-times higher rate compared to the general population [5, 6]. For example, the presumably large number of unreported and unofficial numbers of suicides in the general population is not sufficiently taken into account as a comparison group whereas the number of unreported cases in prison settings is relatively low due to close monitoring. The arising problem is the difficulty to compare the suicide rates of those two groups. Statistics can be distorted as well by varying definitions of suicide; some studies include the overdose of drugs or are unable to include suicidal intentions covered as traffic or household accidents [9]
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