Patterns of self-harm and attempted suicide among white and black/mixed race female prisoners.

Abstract

The aim was to investigate ethnic differences in lifetime self-harm and attempted suicide in women prisoners, and to examine relationships between self-harm, suicide and substance use on dependence. Previous studies have suggested that there may be ethnic differences in the proportion of prisoners reporting substance misuse, self-harm and attempted suicide, although relatively few minority ethnic women have been studied in the UK. This study examines drug and alcohol dependence in white and black British women in prison, and explores possible associations with self-harm, suicide attempts, and family violence. 301 women (190 white, 111 black or mixed race) were interviewed in ten prisons from different parts of England. Measures included the Alcohol Use Disorders Identification test (AUDIT), the severity of Dependence Scale (SDS), and section C (suicidality) of the MINI International Neuropsychiatric Interview. Half of the women in the sample reported at least one act of self-harm in their life and 46% reported making a suicide attempt at some time. Lifetime self-harm was associated with a history of harmful drinking and with being a victim of violence, including physical assault, sexual assault and violence from family and friends. Lifetime suicide attempts were associated with reported violence from family or friends. Current high suicide risk was most common among women on remand. Drug dependence and reported violence from family or friends were both more common amongst white women than black/mixed race women. Self-harm and attempted suicide were generally more common among white women, but black/mixed race women dependent on drugs had the highest proportion of women reporting self-harm. There was tentative support for a three-way association between ethnicity, dependence and self-harm; this raises the possibility that drug dependence may be a predictor of self-harm in the black female prison population.