Suicidal behavior in individuals accused or convicted of child sex abuse or indecent image offenses: Systematic review of prevalence and risk factors.

Rebecca Key,Frank Farnham,Keith Hawton,Lisa Marzano,Alan Underwood

doi:10.1111/sltb.12749

Abstract

An emerging body of research indicates that child sex abuse (CSA) offenders are at high risk of suicide when their offenses come to light and that those accused of accessing indecent images of children (IIOC) are at particular risk. We conducted a systematic review and narrative synthesis on suicide rates and risk factors in this population of offenders. A keyword search of bibliographic databases (PsycINFO, Ovid, MEDLINE, Embase, PILOTS, SCIE, the Cochrane Central Register of Controlled Trials [CENTRAL] and CINAHL) was conducted. Eighteen articles were included in the review, with eleven studies meeting criteria for quality assessment. The risk of suicide in perpetrators of CSA and IIOC might be over 100 times that of the general population, although estimates vary widely between studies. Several complex, interlinking factors were identified as associated with risk, including shame, unique demographic characteristics of the offenders, absence of prior criminal contact, and the impact of a criminal investigation. The review identified factors that may have practical, clinical, and operational implications in the prevention of suicide in CSA and IIOC perpetrators. Exploring the impact of the investigation itself on suicide risk, including potential operational strategies and clinical input to reduce risk, should be a priority.

Highlights

Reducing the risk of suicide in high-risk groups is a key element of suicide prevention strategies worldwide
This review has highlighted the paucity of research investigating factors which are likely to contribute to an increased risk of suicide in perpetrators of child sex abuse (CSA), especially those involved in indecent images of children (IIOC) offenses
These factors include the intensity of shame and stigma, the impact of the criminal investigation, and the unique demographics and socioeconomic status of this group compared with other people dying by suicide

Summary

Introduction

Reducing the risk of suicide in high-risk groups is a key element of suicide prevention strategies worldwide. This includes individuals in contact with the criminal justice system (HM Government, 2012; King et al, 2015; Linsley et al, 2007) and, among them, perpetrators of child sex abuse (CSA) (Brophy, 2003; Linsley et al, 2007; Pritchard & King, 2005; Ward & Siegert, 2002). Internet offenses relating to the use of children in indecent materials is one form of CSA that has sharply increased in prevalence (Child Exploitation & Online Protection Centre, 2012; Merdian et al, 2009). Offenses in England and Wales increased by 69% between 2014/15 and 2015/16 (Bentley et al, 2016)

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Discussion

Conclusion