Suizid in Haft - europäische Entwicklungen unter Berücksichtigung der Situation in der Schweiz

Abstract

In many places suicide is the leading cause of death in prison. Based on the results of international suicide research, there is a consensus that the suicide rate in penal institutions is several times higher than for thegeneral population. One possible explanation is that the most commonly used method - hanging - is associated with a more limited chance of being saved than the methods frequently used in suicide attempts outside prison. Here it is also important to take into account that the prison population is not a representative sample of the general population. In prison groups are overrepresented that are at especially high risk of suicide, above all those with addictions. There is a greater suicide risk during remand on custody than among sentenced prisoners, especially at the beginning of imprisonment. This may be explained by the condition described as shock, that is by imprisonment as a stress factor which greatly varies from individual to individual. Among those with dependence disorders, withdrawal symptoms have been identified as important stressors. At that time uncertainty about the future is greatest. The population in prison on remand is characterised by a higher turnover, in particular a higher rate of new admissions than among sentenced prisoners, and there is also evidence for a higher prevalence of psychiatric disorders among those on remand. A higher risk of suicide has been described among those guilty of homicide and sexual offences. This has been explained by the long sentences anticipated by this population, the psychodynamic model of internalisation of aggression and the helplessness and hopelessness which may characterise long sentences. It is still an open question how far the process of stabilisation which has been described in longitudinal studies among those serving long sentences might also be a sign of damage by imprisonment, reflecting sinking vitality and diminishing abilities to cope with life outside prison. The article deals with the question which development of suicide rates has taken place since 1983, on the one hand in the general population between the age of 15 and 44 and on the other hand in the male prison population in Switzerland and in other European countries. The suicide rates of the general population between the age of 15 and 44 dropped between the period 1983 to 1986 and the period 1991 to 1994 in Switzerland, but rose in most of the European countries. In the penal institutions the suicide rates increased between the periods 1983 to 1986 in comparison with 1995 to 1998 in Switzerland as in the majority of the European countries. Confirming previous studies, we found the suicide rates in the custodial institutions in Switzerland to be higher than within the general population, although there is a decrease in the proportion in comparison with the situation in the seventies. Due to the lack of internationally uniform standards, the results should, on the whole, be evaluated critically. Thus, it is necessary to perform further research on dealing with prisoners at risk of suicide: in addition to the prevalence of psychic disorders and structural conditions, other variables like more lenient confinement and occupancy practices must also be considered. It is conceivable that strategies of concentrating prisoners with serious violent crimes and correspondingly long prison terms intensify feelings of hopelessness and helplessness.