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Suicide Risk Factors Among Recently Released Prisoners

D. Pratt, L. Appleby, M. Piper, R. Webb, and J. Shaw. (2010). Suicide in recently released prisoners: A case-control study. Psychological Medicine, 40(5):827-835.

By Lori Whitten, Staff Writer, RTI International, Rockville, MD

Release from prison represents a critical—and risky—turning point for ex-offenders; newly released inmates  have a markedly higher risk of suicide than the general population. Knowing the risk factors for suicide after prison release could help correctional staff identify and intervene with those who are in most need support to make the transition to the community. But information is lacking. This is a photograph, shot from behind, of a man wearing a hoodie, hands in pocket, walking alone on a high, rural mountain road.

To help fill that knowledge gap, Jennifer Shaw, M.D., Ph.D., and colleagues at the University of Manchester in the United Kingdom examined all suicides committed by offenders within 12 months of their release from prisons in England and Wales between 2000 and 2002. For each case of offender suicide, they randomly selected one control and matched these individuals based on gender and date of release from prison. For three cases, no prisoner of the same gender had been released from prison on the same day, so the researchers excluded these individuals from the case-control comparisons.

Of the 256,920 prisoners released during the 3-year study period, 384 committed suicide within 1 year of entering the community. Shaw and colleagues found that the same characteristics linked with suicide among people in prison, according to prior research, were also associated with an elevated risk of suicide among offenders in the community. They include being older than 25, a history of alcohol misuse or self-harm, a psychiatric diagnosis, contact with mental health services during incarceration, and being identified as requiring Community Mental Health Services after release. The researchers also found that individuals who committed suicide after prison release were half as likely to have received supervision by probation services as those who did not. Former inmates of non-white ethnicity and those with a history of previous imprisonment (and longer stays in prison) were found to be less likely to commit suicide during the year after prison release.

Based on their findings, Shaw and colleagues suggest that prisons in England and Wales have improved how they identify inmates at risk for suicide and provide mental health services during incarceration (see graph). “However, once the individual walked out through the prison gates, far less emphasis seemed to be placed upon suicide prevention,” the authors say (p. 833). To address this problem, the researchers suggest that prisons and the National Health Service focus on those most at risk and integrate steps for suicide prevention into each individual’s release plan. Because prison release can be unpredictable, especially for inmates who have not yet been convicted, staff should develop release plans as soon as possible after individuals enter the correctional facility and update as necessary. Better coordination among the community agencies that assist newly released prisoners with vital services—including probation supervision, primary health care, and community mental health, substance misuse, and social support—might help prevent suicides among these vulnerable individuals.

For more information contact Dr. Jennifer Shaw at the School of Community-Based Medicine, University of Manchester in Manchester, United Kingdom, jennifer.shaw@manchester.ac.uk.

Some Differences Between Prisoners Who Did And Those Who Did Not Commit Suicide

A comparison of offenders who committed suicide within 12 months of their release from prison and those who did not suggests that mental health care begun during incarceration should continue in the community.

 

This bar graph indicates that offenders and former offenders who were diagnosed or treated for mental illness had higher rates of suicide than those who were not.




Posted Mon, Jul 16 2012 12:58 PM by Tracey Vessels

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