Abstract
PurposePrisoners have a higher risk of suicide compared to non-incarcerated individuals. One aim of suicide prevention for prisoners is to identify risk factors in order to put stronger support mechanisms in place for the more vulnerable detainees. This study investigates the suicide risk (SR) in offence-related sub-populations in a representative German sample and differentiates between SR for adolescent and adult prisoners.MethodsConducting a national study with data from public German records on the entire prison population from 2000 to 2016 and suicide numbers in German prisons in the same period, SR was calculated for the total male prison population as well as for both subgroups, adolescent and adult male prisoners.ResultsIn the study period, male prisoners spent 959.584 life years (LY) in German criminal detention. Among those, 524 prisoners died of suicide. SR was higher for detainees imprisoned for an offence resulting in extensive physical harm for another person, e.g. homicide (suicide rate = 134,8 suicides per 100.000 LY; OR = 2,47; CI95%: 1,98–3,08), bodily injury (suicide rate = 87,3; OR = 1,60; CI95%: 1,29–1,99), and sexual offences (suicide rate = 84,2; OR = 1,54; CI95%: 1,18–2,01) compared with the SR of the total prison population (suicide rate = 54.6). Age differences between offence-related SR were found for theft, with adolescents (suicide rate = 69,3; OR = 1,25; CI95%: 0,85–1,84) showing higher SR than adults (suicide rate = 38,2; OR = 0,7; CI95%: 0,54–0,92).ConclusionThe index offence of detainees is associated with SR and age-related differences exist. Suicide prevention in prisons should take both into account to determine populations at risk.
Highlights
Suicide prevention is a public health imperative [1] and according to WHO guidelines, it is crucial that in the course of public health suicide prevention approaches high-risk groups are identified and psychiatric support is provided [2].Suicide and delinquencySeveral large epidemiological studies and reviews show an association of delinquent behaviour and suicide [3,4,5,6,7]
suicide risks (SR) was higher for detainees imprisoned for an offence resulting in extensive physical harm for another person, e.g. homicide, bodily injury, and sexual offences compared with the SR of the total prison population
Age differences between offence-related SR were found for theft, with adolescents showing higher SR than adults
Summary
Suicide prevention is a public health imperative [1] and according to WHO guidelines, it is crucial that in the course of public health suicide prevention approaches high-risk groups are identified and psychiatric support is provided [2].Suicide and delinquencySeveral large epidemiological studies and reviews show an association of delinquent behaviour and suicide [3,4,5,6,7]. Individual risk factors that may apply to detainees even before imprisonment These can be prior suicide attempts, misuse- or dependence of drugs, psychiatric disorders and impulsive character traits [11,12]. In addition to this imported risk-profile detainees are confronted with stressors that constitute environmental risk factors. These can be associated with prison characteristics like e.g., overcrowding and high turnover [13], perceived lack of control, isolation from family and significant other, fear of the unknown, distrust of an authoritarian environment, perceived lack of control over the future, shame or guilt over the alleged offences [14]. Imprisonment may exacerbate a momentary crisis situation, which may act as a situational risk factor (e.g. committal to prison, pronouncement of sentencing)
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