Lifetime prevalence and correlates of self-harm and suicide attempts among male prisoners with histories of injecting drug use

Ashleigh C Stewart,Stuart A Kinner,Paul Dietze,Michael Curtis,Gregory Armstrong,Mark Stoové,Reece Cossar,James R P Ogloff,Amy Kirwan

doi:10.1186/s40352-018-0077-2

Abstract

BackgroundHistories of self-harm and suicide attempts are common among people in prison in Australia, and substance dependence is an established risk factor for these lifetime experiences. We describe the prevalence of self-reported history of non-suicidal self-injury (NSSI) and suicide attempts in a cohort of men with recent histories of injecting drug use (IDU) imprisoned in Victoria, Australia. Baseline interviews from the Prison and Transition Health (PATH) prospective cohort study were conducted in the weeks prior to release from prison among 400 incarcerated men who reported regular IDU in the six months prior to incarceration.ResultsParticipants completed a researcher-administered structured questionnaire that collected information on sociodemographics, substance use patterns, and physical and mental health indicators. More than one third (37%) reported a history of NSSI and almost half of participants (47%) reported a history of suicide attempts. In multivariable Poisson regression models, a history of NSSI was associated with: being aged 30–39 years; moving accommodation three or more times in the year prior to current sentence; self-reporting a history of mental illness diagnosis; current poor psychiatric well-being; and self-reporting three or more previous drug overdoses. History of suicide attempts was significantly associated with: self-reporting a history of mental illness diagnosis; current poor psychiatric well-being; and self-reporting a history of 1–2 and > 3 drug overdoses.ConclusionWe observed a disconcertingly high lifetime prevalence of non-suicidal self-injury and suicide attempts among incarcerated males with a history of recent regular injecting drug use. Significant associations with indicators of mental illness and drug related harms support the need to prioritise in-prison screening and early intervention to reduce the risk of future harms for this population.

Highlights

Histories of self-harm and suicide attempts are common among people in prison in Australia, and substance dependence is an established risk factor for these lifetime experiences
Suicide rates among people who inject drugs (PWID) have been estimated at 14 times that seen in the general population, while the major risk factors associated with self-harm and suicide including psychological distress, family conflict and social isolation are over-represented among PWID (Darke and Ross, 2002)
In this study, we explored the characteristics associated with history of non-suicidal self-injury (NSSI) and history of suicide attempts in a sample of incarcerated men in Australia reporting a history of recent regular injecting drug use (IDU) prior to their current sentence

Summary

Introduction

Histories of self-harm and suicide attempts are common among people in prison in Australia, and substance dependence is an established risk factor for these lifetime experiences. We describe the prevalence of self-reported history of non-suicidal self-injury (NSSI) and suicide attempts in a cohort of men with recent histories of injecting drug use (IDU) imprisoned in Victoria, Australia. A key contributor to this disproportionate rate of suicide and self-harm in prisoner populations is the strong association among people with a history of injecting drug use (IDU) (Darke & Ross, 2002), a characteristic. Suicide rates among PWID have been estimated at 14 times that seen in the general population, while the major risk factors associated with self-harm and suicide including psychological distress, family conflict and social isolation are over-represented among PWID (Darke and Ross, 2002). There is some evidence of an association between history of overdose and history of suicide attempts, this association remains unclear in the context of accidental overdose and substance misuse (Maloney et al, 2009)

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