Self-harm and suicidal behaviour among incarcerated adults in the Australian Capital Territory

Amanda Butler,Rohan Borschmann,Stuart A Kinner,Jesse T Young

doi:10.1186/s40352-018-0071-8

Abstract

BackgroundSuicide is the leading cause of death in prisons worldwide. Improved understanding of the factors associated with suicide is necessary to inform targeted suicide prevention and interventions. Here we aim to (a) document the prevalence of suicide attempts, suicidal ideation, self-harm, and mental disorder; and (b) identify demographic, mental health, and criminal justice correlates of suicidal ideation, in a sample of incarcerated adults in Australia.MethodsData were obtained from the 2016 Detainee Health and Wellbeing Survey conducted in the Alexander Maconochie Centre, the Australian Capital Territory’s only adult prison. Interviews with 98 incarcerated adults were conducted in October 2016. Descriptive statistics were calculated for all measures. Crude differences between participants who reported experiencing suicidal ideation in their lifetime and those who did not were compared using Fisher’s exact test.ResultsNearly half of the participants (48%, n = 47) reported lifetime suicidal ideation and 31% (n = 30) reported attempting suicide at some point in their lives. Eighteen participants (18%) reported a lifetime history of having engaged in self-harm. Factors significantly associated with suicidal ideation included lifetime history of mental disorder, self-harm, experiencing a drug overdose, and being hospitalized in the past 12 months.ConclusionThe burden of suicidal ideation and prior suicide attempts among people in prison is substantial. Incarceration is a pivotal opportunity to identify people with a history of mental health problems and target interventions aimed at reducing adverse outcomes including suicide mortality.

Highlights

Suicide is the leading cause of death in prisons worldwide
Self-harm is often repetitive; a meta-analysis of 90 studies from Europe and the UK estimated that at least 15% of people who were hospitalized for self-harm in the community had more than one self-harm event within 1 year of release from hospital, and two-thirds of suicide deaths were preceded by self-harm (Owens et al 2002)
The aims of the current paper were to (a) document the prevalence of self-harm, suicidal behavior, and mental disorder; and (b) identify demographic, mental health and criminal justice correlates of suicidal behavior, in a sample of incarcerated adults in Australia

Summary

Introduction

Suicide is the leading cause of death in prisons worldwide. Improved understanding of the factors associated with suicide is necessary to inform targeted suicide prevention and interventions. Suicide is the leading cause of death among incarcerated adults worldwide and preventing suicide in prison has become an international priority (Marzano et al 2016; World Health Organization 2007). Suicide attempts, self-harm history, and mental health disorders are predictors of future suicide and, as such, are targets for prevention and treatment (Borschmann et al 2016; Fazel et al 2008; Skegg 2005). A meta-analysis of nearly 5000 suicide deaths in prisons (mostly in the US) found that the risk of suicide was 15 times higher among those who experienced recent suicidal ideation, and approximately 50% of people who died by suicide in prison had a history of self-harm (Fazel et al 2008). Mental disorders are overrepresented among incarcerated adults and mental disorders are strong predictors of both suicide and self-harm (Borschmann et al 2016; Fazel and Seewald 2012; Prins 2014; Skegg 2005)

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