Suicide in prisons: an international study of prevalence and contributory factors

<h4>Background</h4> <p>Prison suicide rates, rate ratios, and associations with prison-related factors need clarification and updating.</p> <h4>Methods</h4> <p> We collected data on prison suicides in 24 high-income countries in Europe, Australasia and Nort...

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Main Authors: Fazel, SB, Ramesh, T, Hawton, K
Format: Journal article
Published: Elsevier 2017
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author Fazel, SB
Ramesh, T
Hawton, K
author_facet Fazel, SB
Ramesh, T
Hawton, K
author_sort Fazel, SB
collection OXFORD
description <h4>Background</h4> <p>Prison suicide rates, rate ratios, and associations with prison-related factors need clarification and updating.</p> <h4>Methods</h4> <p> We collected data on prison suicides in 24 high-income countries in Europe, Australasia and North America from their prison administrations for 2011-2014 to calculate suicide rates and rate ratios compared to the general population. We used meta-regression to test associations with general population suicide rates, incarceration rates, and prison-related factors (overcrowding, ratio of prisoners to prison officers/healthcare/education staff, daily spend, turnover, and imprisonment duration). We also examined temporal trends. </p> <h4>Findings</h4> <p>There were 3,906 prison suicides during 2011-2014, and 93% were in men. Nordic countries had the highest prison suicide rates of more than 100 suicides per 100,000 prisoners apart from Denmark (where it was 91/100,000), followed by Western Europe where prison suicide rates in France and Belgium were more than 100/100,000. Australasian and North American countries had rates ranging from 23 to 67 suicides per 100,000 prisoners. Rate ratios were typically higher than 3 in men and 9 in women. Higher incarceration rates were associated with lower prison suicide rates (b = -0.504, p = 0.014), which was attenuated when adjusting for prison-level variables. There were no associations between rates of prison suicide and general population suicide, any other tested prison-related factors, or differing criteria for defining suicide deaths. Changes in prison suicide rates over the last decade vary widely between countries.</p> <h4>Interpretation</h4> <p>Many countries in Northern and Western Europe have prison suicide rates of more than 100 per 100,000 prisoners. Individual level information on prisoner health is required to understand the substantial variations reported and changes over time.</p>
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spelling oxford-uuid:f9fb82b1-0cfd-48b2-b000-8f435fb502b12022-03-27T13:02:11ZSuicide in prisons: an international study of prevalence and contributory factorsJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:f9fb82b1-0cfd-48b2-b000-8f435fb502b1Symplectic Elements at OxfordElsevier2017Fazel, SBRamesh, THawton, K <h4>Background</h4> <p>Prison suicide rates, rate ratios, and associations with prison-related factors need clarification and updating.</p> <h4>Methods</h4> <p> We collected data on prison suicides in 24 high-income countries in Europe, Australasia and North America from their prison administrations for 2011-2014 to calculate suicide rates and rate ratios compared to the general population. We used meta-regression to test associations with general population suicide rates, incarceration rates, and prison-related factors (overcrowding, ratio of prisoners to prison officers/healthcare/education staff, daily spend, turnover, and imprisonment duration). We also examined temporal trends. </p> <h4>Findings</h4> <p>There were 3,906 prison suicides during 2011-2014, and 93% were in men. Nordic countries had the highest prison suicide rates of more than 100 suicides per 100,000 prisoners apart from Denmark (where it was 91/100,000), followed by Western Europe where prison suicide rates in France and Belgium were more than 100/100,000. Australasian and North American countries had rates ranging from 23 to 67 suicides per 100,000 prisoners. Rate ratios were typically higher than 3 in men and 9 in women. Higher incarceration rates were associated with lower prison suicide rates (b = -0.504, p = 0.014), which was attenuated when adjusting for prison-level variables. There were no associations between rates of prison suicide and general population suicide, any other tested prison-related factors, or differing criteria for defining suicide deaths. Changes in prison suicide rates over the last decade vary widely between countries.</p> <h4>Interpretation</h4> <p>Many countries in Northern and Western Europe have prison suicide rates of more than 100 per 100,000 prisoners. Individual level information on prisoner health is required to understand the substantial variations reported and changes over time.</p>
spellingShingle Fazel, SB
Ramesh, T
Hawton, K
Suicide in prisons: an international study of prevalence and contributory factors
title Suicide in prisons: an international study of prevalence and contributory factors
title_full Suicide in prisons: an international study of prevalence and contributory factors
title_fullStr Suicide in prisons: an international study of prevalence and contributory factors
title_full_unstemmed Suicide in prisons: an international study of prevalence and contributory factors
title_short Suicide in prisons: an international study of prevalence and contributory factors
title_sort suicide in prisons an international study of prevalence and contributory factors
work_keys_str_mv AT fazelsb suicideinprisonsaninternationalstudyofprevalenceandcontributoryfactors
AT ramesht suicideinprisonsaninternationalstudyofprevalenceandcontributoryfactors
AT hawtonk suicideinprisonsaninternationalstudyofprevalenceandcontributoryfactors