Risk Factors for Self-Harm and Suicide in Incarcerated Young Offenders: Implications for Policy and Practice

Abstract

This study identified common and unique risk factors for suicidal and self-harming (SSH) behavior in 242 incarcerated young offenders. Lifetime prevalence of suicidal ideation was 19.2% and was 18.2% for self-harm ideation; 8.4% had attempted suicide (44% in detention), and 9.1% had inflicted self-harm in the past 12 months (75% in detention). SSH young offenders reported more severe psychopathology, childhood trauma, and psychological distress than non-SSH young offenders. Past emotional abuse, current psychological distress, and depersonalization disorder were significant risk factors for suicidal ideation. Past physical abuse and current psychological distress were significant risk factors for self-harm ideation. Suicidality and self-harm co-occurred. Two approaches to the assessment of self-harm risk—past behavior and scores on a scale of self-harm risk—were compared. Some support for the equivalence of assessment methods was found; however, significant differences emerged that indicated that a multi-factorial approach to the assessment of self-harm risk is advised. Screening on entry to detention could identify young offenders at risk and direct them into treatment. The high rates of self-harm in detention suggest that the detention environment and management practices should be reviewed to identify structural elements that contribute to distress in some young offenders that for a significant minority is associated with SSH ideation and behavior.