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Psychiatric and social aspects of suicidal behaviour in prisons

Published online by Cambridge University Press:  21 January 2005

RACHEL JENKINS ,
DINESH BHUGRA ,
HOWARD MELTZER ,
NICOLA SINGLETON ,
PAUL BEBBINGTON ,
TRALOACH BRUGHA ,
JEREMY COID ,
MIKE FARRELL ,
GLYN LEWIS  and
JO PATON
RACHEL JENKINS
Affiliation:
WHO Collaborating Centre, David Goldberg Centre, Institute of Psychiatry, Denmark Hill, London; MRC Social and Psychiatry Unit, Institute of Psychiatry, Denmark Hill, London; Office of National Statistics, Social Survey Division, 1 Drummond Gate, London; Royal Free & University College London Medical School, UCL – Department of Mental Health Sciences, London; Department of Health Services, University of Leicester; Department of Forensic Psychiatry, William Harvey House, St Bartholomew's Hospital, West Smithfield, London; Division of Psychiatry, Cotham House, Cotham Hill, Bristol; HM Prison Service
DINESH BHUGRA
Affiliation:
WHO Collaborating Centre, David Goldberg Centre, Institute of Psychiatry, Denmark Hill, London; MRC Social and Psychiatry Unit, Institute of Psychiatry, Denmark Hill, London; Office of National Statistics, Social Survey Division, 1 Drummond Gate, London; Royal Free & University College London Medical School, UCL – Department of Mental Health Sciences, London; Department of Health Services, University of Leicester; Department of Forensic Psychiatry, William Harvey House, St Bartholomew's Hospital, West Smithfield, London; Division of Psychiatry, Cotham House, Cotham Hill, Bristol; HM Prison Service
HOWARD MELTZER
Affiliation:
WHO Collaborating Centre, David Goldberg Centre, Institute of Psychiatry, Denmark Hill, London; MRC Social and Psychiatry Unit, Institute of Psychiatry, Denmark Hill, London; Office of National Statistics, Social Survey Division, 1 Drummond Gate, London; Royal Free & University College London Medical School, UCL – Department of Mental Health Sciences, London; Department of Health Services, University of Leicester; Department of Forensic Psychiatry, William Harvey House, St Bartholomew's Hospital, West Smithfield, London; Division of Psychiatry, Cotham House, Cotham Hill, Bristol; HM Prison Service
NICOLA SINGLETON
Affiliation:
WHO Collaborating Centre, David Goldberg Centre, Institute of Psychiatry, Denmark Hill, London; MRC Social and Psychiatry Unit, Institute of Psychiatry, Denmark Hill, London; Office of National Statistics, Social Survey Division, 1 Drummond Gate, London; Royal Free & University College London Medical School, UCL – Department of Mental Health Sciences, London; Department of Health Services, University of Leicester; Department of Forensic Psychiatry, William Harvey House, St Bartholomew's Hospital, West Smithfield, London; Division of Psychiatry, Cotham House, Cotham Hill, Bristol; HM Prison Service
PAUL BEBBINGTON
Affiliation:
WHO Collaborating Centre, David Goldberg Centre, Institute of Psychiatry, Denmark Hill, London; MRC Social and Psychiatry Unit, Institute of Psychiatry, Denmark Hill, London; Office of National Statistics, Social Survey Division, 1 Drummond Gate, London; Royal Free & University College London Medical School, UCL – Department of Mental Health Sciences, London; Department of Health Services, University of Leicester; Department of Forensic Psychiatry, William Harvey House, St Bartholomew's Hospital, West Smithfield, London; Division of Psychiatry, Cotham House, Cotham Hill, Bristol; HM Prison Service
TRALOACH BRUGHA
Affiliation:
WHO Collaborating Centre, David Goldberg Centre, Institute of Psychiatry, Denmark Hill, London; MRC Social and Psychiatry Unit, Institute of Psychiatry, Denmark Hill, London; Office of National Statistics, Social Survey Division, 1 Drummond Gate, London; Royal Free & University College London Medical School, UCL – Department of Mental Health Sciences, London; Department of Health Services, University of Leicester; Department of Forensic Psychiatry, William Harvey House, St Bartholomew's Hospital, West Smithfield, London; Division of Psychiatry, Cotham House, Cotham Hill, Bristol; HM Prison Service
JEREMY COID
Affiliation:
WHO Collaborating Centre, David Goldberg Centre, Institute of Psychiatry, Denmark Hill, London; MRC Social and Psychiatry Unit, Institute of Psychiatry, Denmark Hill, London; Office of National Statistics, Social Survey Division, 1 Drummond Gate, London; Royal Free & University College London Medical School, UCL – Department of Mental Health Sciences, London; Department of Health Services, University of Leicester; Department of Forensic Psychiatry, William Harvey House, St Bartholomew's Hospital, West Smithfield, London; Division of Psychiatry, Cotham House, Cotham Hill, Bristol; HM Prison Service
MIKE FARRELL
Affiliation:
WHO Collaborating Centre, David Goldberg Centre, Institute of Psychiatry, Denmark Hill, London; MRC Social and Psychiatry Unit, Institute of Psychiatry, Denmark Hill, London; Office of National Statistics, Social Survey Division, 1 Drummond Gate, London; Royal Free & University College London Medical School, UCL – Department of Mental Health Sciences, London; Department of Health Services, University of Leicester; Department of Forensic Psychiatry, William Harvey House, St Bartholomew's Hospital, West Smithfield, London; Division of Psychiatry, Cotham House, Cotham Hill, Bristol; HM Prison Service
GLYN LEWIS
Affiliation:
WHO Collaborating Centre, David Goldberg Centre, Institute of Psychiatry, Denmark Hill, London; MRC Social and Psychiatry Unit, Institute of Psychiatry, Denmark Hill, London; Office of National Statistics, Social Survey Division, 1 Drummond Gate, London; Royal Free & University College London Medical School, UCL – Department of Mental Health Sciences, London; Department of Health Services, University of Leicester; Department of Forensic Psychiatry, William Harvey House, St Bartholomew's Hospital, West Smithfield, London; Division of Psychiatry, Cotham House, Cotham Hill, Bristol; HM Prison Service
JO PATON
Affiliation:
WHO Collaborating Centre, David Goldberg Centre, Institute of Psychiatry, Denmark Hill, London; MRC Social and Psychiatry Unit, Institute of Psychiatry, Denmark Hill, London; Office of National Statistics, Social Survey Division, 1 Drummond Gate, London; Royal Free & University College London Medical School, UCL – Department of Mental Health Sciences, London; Department of Health Services, University of Leicester; Department of Forensic Psychiatry, William Harvey House, St Bartholomew's Hospital, West Smithfield, London; Division of Psychiatry, Cotham House, Cotham Hill, Bristol; HM Prison Service
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Abstract

Background. Suicidal behaviour and completed suicide are serious problems within British prisons, leading to significant morbidity and mortality, and are the focus of major efforts towards their prevention.

Aim. To explore the demographic, social and psychiatric correlates of suicidal behaviour in prisons in England and Wales and their relationship with health service use; and to develop a combined psychosocial model of risk.

Method. This report analyses the prevalence of suicidal ideation and suicide attempts in the ONS National Prison Survey, and their association with the presence of psychiatric disorders, personality disorder, substance abuse and social risk factors. These data were compared with data from the second national survey of psychiatric morbidity in adults living at home. In both surveys, a two-phase interviewing procedure was used, covering general health, health service use, assessment of psychiatric disorders, life events, social supports, suicidal behaviour, activities of daily living, sociodemographic data, substance abuse and intelligence.

Results. Suicidal thoughts and suicide attempts were commoner in prisons than in the general population and these were significantly associated with higher rates of psychosis, neurosis and personality disorder in prisons. In addition, demographic and factors such as being young, single, white, leaving school early and experiencing poor social support and significant social adversity were important risk factors for suicidal thoughts. Crucially, there was no separate category of people at suicidal risk who did not have psychiatric disorders.

Conclusions. The high rates of suicidal behaviour in prisons cannot be addressed without adequate attention to the high rates of psychiatric disorder and vulnerability factors in prisoners.

Type
Research Article
Information
Psychological Medicine , Volume 35 , Issue 2 , February 2005 , pp. 257 - 269
Copyright
© 2004 Cambridge University Press

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