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Chiappini S, Vaccaro G, Mosca A, Miuli A, Stigliano G, Stefanelli G, Giovannetti G, Carullo R, d'Andrea G, Di Carlo F, Cavallotto C, Pettorruso M, Di Petta G, Corkery JM, Guirguis A, Stair JL, Martinotti G, Fazel S, Schifano F. New trends of drug abuse in custodial settings: A systematic review on the misuse of over-the-counter drugs, prescription-only-medications, and new psychoactive substances. Neurosci Biobehav Rev 2024; 162:105691. [PMID: 38733894 DOI: 10.1016/j.neubiorev.2024.105691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 04/22/2024] [Accepted: 04/24/2024] [Indexed: 05/13/2024]
Abstract
The article presents a systematic literature review on the use and the psychiatric implications of over-the-counter drugs (OTC), prescription-only-medications (POM), and new psychoactive substances (NPS) within custodial settings. The searches wer carried out on 2 November 2022 on PubMed, Scopus, and Web of Science in line with PRISMA guidelines. A total of 538 records were identified, of which 37 met the inclusion criteria. Findings showed the most prevalent NPS and OTC and POM classes reported in prisons were synthetic cannabinoids receptor agonists (SCRAs) and opioids, respectively. NPS markets were shown to be in constant evolution following the pace of legislations aimed to reduce their spread. The use of such substances heavily impacts the conditions and rehabilitation of persons in custody, with consequent physical and mental health risks. It is important to raise awareness of the use and misuse of such substances in prisons (i) from an early warning perspective for law enforcement and policy makers (ii) to prompt doctors to cautiously prescribe substances that may be misused (iii) to improve and increase access to treatment provided (iv) to add such substances to routine toxicological screening procedures (v) to improve harm reduction programmes.
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Affiliation(s)
- Stefania Chiappini
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hertfordshire AL10 9EU, UK; Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Chieti 66100, Italy
| | - Giorgia Vaccaro
- Department of Clinical, Pharmaceutical and Biological Sciences, School of Life and Medical Sciences, University of Hertfordshire, Hertfordshire AL10 9EU, UK
| | - Alessio Mosca
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Chieti 66100, Italy.
| | - Andrea Miuli
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Chieti 66100, Italy
| | - Gianfranco Stigliano
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Chieti 66100, Italy
| | - Giulia Stefanelli
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Chieti 66100, Italy
| | - Giulia Giovannetti
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Chieti 66100, Italy
| | - Rosalba Carullo
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Chieti 66100, Italy
| | - Giacomo d'Andrea
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Chieti 66100, Italy
| | - Francesco Di Carlo
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Chieti 66100, Italy
| | - Clara Cavallotto
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Chieti 66100, Italy
| | - Mauro Pettorruso
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Chieti 66100, Italy
| | - Gilberto Di Petta
- Department of Neuroscience Department of Mental Health, ASL Napoli 2, Napoli, Nord, Italy
| | - John Martin Corkery
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hertfordshire AL10 9EU, UK
| | - Amira Guirguis
- Swansea University Medical School, Grove Building, Swansea University, Singleton Park, Swansea, Wales SA28PP, UK
| | - Jacqueline L Stair
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hertfordshire AL10 9EU, UK
| | - Giovanni Martinotti
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hertfordshire AL10 9EU, UK; Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Chieti 66100, Italy
| | - Seena Fazel
- Department of Psychiatry, University of Oxford, and Oxford Health NHS Foundation Trust, England
| | - Fabrizio Schifano
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hertfordshire AL10 9EU, UK
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Mundt AP, Cifuentes-Gramajo PA, Baranyi G, Fazel S. Worldwide incidence of suicides in prison: a systematic review with meta-regression analyses. Lancet Psychiatry 2024; 11:536-544. [PMID: 38823401 DOI: 10.1016/s2215-0366(24)00134-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 04/11/2024] [Accepted: 04/16/2024] [Indexed: 06/03/2024]
Abstract
BACKGROUND Suicide is a leading cause of death during imprisonment. This systematic review aimed to synthesise available evidence of prison suicide incidence worldwide. METHODS We systematically searched the scientific literature, data repositories, and prison system reports, supplemented by correspondence with prison administrations. We included reports on people living in prison but excluded studies in preselected groups (by age or offence type). Absolute numbers and incidence rates of suicide mortality per 100 000 person-years by sex and country were extracted from 2000 to 2021. IQRs were used to describe the suicide incidence in different world regions. Incidence rate ratios comparing suicides of people living in prison with age-standardised general populations were calculated. We conducted meta-regression analyses on national-level and prison-level factors to examine heterogeneity. The study protocol was pre-registered with PROSPERO, CRD42021296819. FINDINGS We included three scientific studies, 124 official reports, and 11 datasets from email correspondence. Between 2000 and 2021, there were 29 711 reported suicides during 91·2 million person-years of imprisonment in 82 jurisdictions worldwide (sex-specific data available for 13 289 individuals: 12 544 [94·4%] male and 745 [5·6%] female individuals). There were large variations between countries, with most studies reporting suicide rates in the range of 24-89 per 100 000 person-years in both sexes (22-86 in male individuals and 25-107 in female individuals). In meta-regression analyses, Europe (vs other regions), high-income countries (vs low-income and middle-income countries), and countries with lower incarceration rates (vs those with higher incarceration rates) had higher suicide rates. Incidence rate ratios between people who are incarcerated and age-standardised general populations in the same jurisdictions were typically in the range of 1·9-6·0 in male and 10·4-32·4 in female individuals. INTERPRETATION Prison services worldwide, and particularly in Europe, should prioritise suicide prevention. Assessment and management of suicide risk in female individuals living in prison need particular attention due to excess mortality relative to community-based populations. Interpretation of synthesised data needs to be done with caution due to high heterogeneity between jurisdictions. FUNDING Agencia Nacional de Investigación y Desarrollo, Economic and Social Research Council, and Wellcome Trust.
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Affiliation(s)
- Adrian P Mundt
- Facultad de Medicina, Universidad Diego Portales, Santiago, Chile; Department of Psychiatry and Mental Health, Hospital Clínico Universidad de Chile, Santiago, Chile.
| | - Pablo A Cifuentes-Gramajo
- Doctorado en Psicoterapia, Medical Faculties and Faculties of Social Sciences, Universidad de Chile and Pontificia Universidad Católica de Chile, Quetzaltenango, Guatemala; Dirección General del Sistema de Investigación, Centro Universitario de Occidente, Universidad de San Carlos de Guatemala, Quetzaltenango, Guatemala
| | - Gergő Baranyi
- Centre for Research on Environment, Society and Health, University of Edinburgh, Edinburgh, UK; Centre for Longitudinal Studies, Institute of Education, University College London, London, UK
| | - Seena Fazel
- Department of Psychiatry, University of Oxford, Oxford, UK; Oxford Health NHS Foundation Trust, Oxford, UK
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Kinner SA, Aon M, Borschmann R. Preventing suicide in people who experience incarceration. Lancet Psychiatry 2024; 11:486-488. [PMID: 38823402 DOI: 10.1016/s2215-0366(24)00171-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Accepted: 05/20/2024] [Indexed: 06/03/2024]
Affiliation(s)
- Stuart A Kinner
- Justice Health Group, enAble Institute, Curtin University, Perth, WA, Australia; School of Population Health, Curtin University, Perth, WA, Australia; Justice Health Group, Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, VIC, Australia; Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia.
| | - Maha Aon
- DIGNITY, Danish Institute Against Torture, Copenhagen, Denmark; Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Rohan Borschmann
- Justice Health Group, enAble Institute, Curtin University, Perth, WA, Australia; Justice Health Group, Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, VIC, Australia; Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia; Department of Psychiatry, Medical Sciences Division, University of Oxford, Oxford, UK
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Bukten A, Virtanen S, Hesse M, Thylstrup B, Kvamme TL, Seid AK, Chang Z, Skjærvø I, Tverborgvik T, Stavseth MR. The prevalence of substance use disorders among people in Norwegian, Danish and Swedish prisons: A multi-national cohort study, 2010-19. Addiction 2024; 119:1264-1275. [PMID: 38529890 DOI: 10.1111/add.16477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 02/18/2024] [Indexed: 03/27/2024]
Abstract
AIMS We estimated the prevalence of substance use disorders (SUDs) in the Norwegian, Danish and Swedish prison populations and compared the prevalence of SUDs in the national prison populations with country-specific general population prevalence rates. DESIGN A multi-national cohort study using data from the National Prison Registries linked to the National Patient Registries in Norway, Denmark and Sweden. SETTING AND PARTICIPANTS We used data from the PriSUD-Nordic study, including national prison populations aged 19 years and older in Norway (2010-19), Denmark (2010-18) and Sweden (2010-13). A total of 119 507 Individuals (108 971 men and 10 536 women) contributing to 191 549 incarcerations were included in the study (Norway: 45432 men; 5429 women, Denmark: 42 162 men; 3370 women, Sweden: 21 377 men; 1737 women). MEASUREMENT We calculated a study prevalence and prevalence at entry to prison for all types of SUDs before imprisonment each consecutive year of observation in each prison population. We also extracted country-specific 1-year prevalence rates from the Global Burden of Diseases database to calculate comparative national prevalence ratios. FINDINGS The study prevalence of any SUD was approximately 40% [Norway: 44.0%, 95% confidence interval (CI) = 43.6-44.5%; Denmark: 39.9%, CI = 39.5-40.4%; Sweden: 39.1%, CI = 38.4-39.7%] in all three countries. Women had a significantly higher study prevalence of any SUD compared with men (Norway: 55.8 versus 42.6%, P < 0.001; Denmark 43.1 versus 39.7%, P = 0.004; Sweden: 51.7 versus 38.0%, P < 0.001). Prevalence estimates were higher for SUDs among people in prison than in the general population. We observed an increasing proportion of people with SUDs entering prison in Norway (P = 0.003), while the proportion was more stable in Denmark and Sweden. CONCLUSIONS Substance use disorders (SUDs) appear to be highly prevalent among the Scandinavian prison populations compared with the general population, especially among women. In Norway, there was a relative increase in SUDs from 2010 to 2019.
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Affiliation(s)
- Anne Bukten
- Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Norway
| | - Suvi Virtanen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Morten Hesse
- Centre for Alcohol and Drug Research, Aarhus University, Aarhus, Denmark
| | - Birgitte Thylstrup
- Centre for Alcohol and Drug Research, Aarhus University, Aarhus, Denmark
| | | | - Abdu Kedir Seid
- Centre for Alcohol and Drug Research, Aarhus University, Aarhus, Denmark
| | - Zheng Chang
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Ingeborg Skjærvø
- Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Norway
| | - Torill Tverborgvik
- Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway
| | - Marianne R Stavseth
- Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Norway
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Knipe D, Vallis E, Kendall L, Snow M, Kirkpatrick K, Jarvis R, Metcalfe C, Eisenstadt N, Bickham V. Suicide Rates in High-Risk High-Harm Perpetrators of Domestic Abuse in England and Wales. CRISIS 2024; 45:242-245. [PMID: 37606346 DOI: 10.1027/0227-5910/a000925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/23/2023]
Abstract
Background A limited amount of research indicates a high prevalence of mental illness in perpetrators of domestic abuse (DA). Aims Estimate the suicide rate in high-risk high-harm perpetrators of DA. Method We utilized data collected as part of Drive, which supports and challenges perpetrators of DA to reduce their harmful behaviors. Using routine anonymized data, we established a cohort of clients (n = 3,475) who were referred via Multi-Agency Risk Assessment Conferences to the service and were followed up during service engagement. Results Most clients were male (92%) and White British (76%) with a median age of 32 years (IQI 27-39). There were 10 male suicide deaths recorded with an estimated male suicide rate of 461 per 100,000 person years (95% CI 248, 856). Limitations Analysis was restricted to those referred to the service and a specific group of perpetrators, limiting the generalizability to all perpetrators of DA. Conclusion The suicide rate in this high-risk high-harm DA perpetrator group is significantly higher than many other high-risk groups. Improving their mental health and outcomes is imperative to reduce the suicide deaths in this group and therefore reduce the impact such deaths would have on the victims of abuse.
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Affiliation(s)
- Duleeka Knipe
- Population Health Sciences, Bristol Medical School, University of Bristol, UK
| | | | | | | | | | | | - Chris Metcalfe
- Population Health Sciences, Bristol Medical School, University of Bristol, UK
| | - Nathan Eisenstadt
- Population Health Sciences, Bristol Medical School, University of Bristol, UK
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Bayrhammer-Savel M, Ortner M, Van Hout MC, Komorowski A. Psychiatric and legal considerations for ketamine treatment within prison settings. Front Psychiatry 2024; 15:1316108. [PMID: 38699451 PMCID: PMC11063772 DOI: 10.3389/fpsyt.2024.1316108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 04/02/2024] [Indexed: 05/05/2024] Open
Abstract
The fundamental right to equivalence of health care in prison settings encompasses the provision of medication to address mental health conditions. Considering the increased risk for self-harm among individuals dealing with depression, the limited effectiveness of conservative antidepressants is a major challenge in psychiatry. The high prevalence of suicidal tendencies within prison populations underscores the imperative for state-of-the-art pharmacological treatment to uphold adequate health care standards. Notably, the denial of access to effective medication could be deemed a violation of human rights of people living in prison according to international treaties, domestic law, and United Nations normative standards of detention. This article presents the authors' perspective on the accessibility of ketamine treatment in prison settings, discussing psychiatric and legal considerations as well as current challenges in this context. Implementing novel psychopharmacological interventions may alleviate the distress experienced by individuals struggling with depressive symptoms and suicidality. At the same time, unprecedented treatment alternatives bring along potential issues, including limited understanding of long-term effects and the risk of abuse. Given the scarce data-availability, a pressing need exists for further research on the benefits and risks of ketamine treatment within prison populations.
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Affiliation(s)
| | - Martin Ortner
- Central Public Prosecutor’s Office for Combating Economic Crimes and Corruption, Vienna, Austria
| | | | - Arkadiusz Komorowski
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
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Vanhaesebrouck A, Fovet T, Melchior M, Lefevre T. Risk factors of suicide in prisons: a comprehensive retrospective cohort study in France, 2017-2020. Soc Psychiatry Psychiatr Epidemiol 2024:10.1007/s00127-024-02661-x. [PMID: 38592476 DOI: 10.1007/s00127-024-02661-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 03/10/2024] [Indexed: 04/10/2024]
Abstract
PURPOSE Suicide is a leading cause of death in prison and the suicide rates are several times higher in the prison population than in the general population in most countries. Of the studies that have investigated risk factors for suicide in prison, few have controlled for possible confounding factors. The aim of this study is to identify risk factors of suicide among people in French prisons, over a four-year period. METHODS All incarcerations that occurred in France during 2017-2020 were eligible. Sociodemographic, criminal and prison characteristics were collected for each incarceration from data of the National Prison Service. Survival univariate and multivariate analyses were performed with a Cox regression model. RESULTS 358,522 incarcerations were included, of which 449 ended in suicide during the follow-up. The median length of prison stay was 5.1 months. The median age at prison entry was 30 years and 95.8% of incarcerations involved men. The overall suicide rate was 173 [157-189] per 100,000 person-years. Factors associated with suicide in the multivariate model (p < 0.05) were the early stage of incarceration and in particular the first week (HR = 7.6 [5.4-10.8]), violent offences and in particular homicide (HR = 3.0 [2.1-4.2]), French (HR = 1.7 [1.2-2.4]) and other European nationalities (HR = 2.1 [1.4-3.3]), age above 40 (HR = 2.0 [1.5-2.6]), pre-trial incarceration (HR = 1.8 [1.4-2.3]), being separated (HR = 1.6 [1.1-2.3] and having a high school diploma (HR = 1.4 [1.0-1.8]). CONCLUSIONS Factors associated with suicide in prison are complex and involve individuals' criminal history as well as conditions of incarceration. These characteristics may be relevant to focus suicide prevention efforts.
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Affiliation(s)
- Alexis Vanhaesebrouck
- Interdisciplinary Research Institute On Social Issues (IRIS), UFR SMBH, Sorbonne Paris North University, UMR 8156‑997, Aubervilliers, France.
- Department of Legal and Social Medicine, Jean-Verdier Hospital (AP-HP), Bondy, France.
- Pierre Louis Institute of Epidemiology and Public Health, Department of Social Epidemiology, Sorbonne University, INSERM, Paris, France.
| | - Thomas Fovet
- CHU Lille, U1172-Lille Neuroscience & Cognition, University Lille, INSERM, 59000 , Lille, France
| | - Maria Melchior
- Pierre Louis Institute of Epidemiology and Public Health, Department of Social Epidemiology, Sorbonne University, INSERM, Paris, France
| | - Thomas Lefevre
- Interdisciplinary Research Institute On Social Issues (IRIS), UFR SMBH, Sorbonne Paris North University, UMR 8156‑997, Aubervilliers, France
- Department of Legal and Social Medicine, Jean-Verdier Hospital (AP-HP), Bondy, France
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Fentahun S, Wondie M, Melkam M, Tadesse G, Tesfaw G. Suicidal ideation, attempt and associated factors among prisoners in Northwest Ethiopia: A cross-sectional study. PLoS One 2024; 19:e0301410. [PMID: 38593147 PMCID: PMC11003691 DOI: 10.1371/journal.pone.0301410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 03/16/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND Suicide is a prominent source of harm and death globally, and it is the leading cause of premature death among prisoners. Therefore, the main aim of this study was to determine the prevalence and factors associated with suicidal ideation and attempt among prisoners in Northwest Ethiopia. METHODS An institution-based cross-sectional study design was performed from May 23 to June 22, 2022. After proportional allocation to the three correctional institutions, a total of 788 study participants were randomly recruited. The World Health Organization Composite International Diagnostic Interview (CIDI) was used to evaluate suicide ideation and attempt. To determine factors associated with suicidal ideation and attempt, multivariate logistic regression analyses were conducted. At a 95% confidence interval (CI) of P-value <0.05, statistical significance was declared. RESULTS The prevalence of suicidal ideation and attempt among prisoners was 23.6% and 10.7%, with 95% CI (20.76, 26.70) and (8.68, 13.02), respectively. Female sex (AOR = 2.38, 95% CI: 1.12, 5.05), family history of mental illness (AOR = 3.09, 95% CI: 1.93, 4.88), depression (AOR = 2.04, 95% CI: 1.43, 2.98), poor social support (AOR = 2.76, 95% CI: 1.56, 4.85) and previous incarceration (AOR = 1.84, 95% CI: 1.18, 2.86) were significantly associated with suicidal ideation. However, being single (AOR = 2.58, 95% CI: 1.47, 4.54), family history of suicide (AOR = 2.43, 95% CI: 1.18, 5.01), depression (AOR = 2.62, 95% CI: 1.59, 4.31) and previous imprisonments (AOR = 2.11, 95% CI: 1.20, 3.69) were associated with suicidal attempt. CONCLUSIONS The prevalence of suicidal ideation and attempt among prisoners were found to be high. Therefore, the findings of this study recommend that early detection and design of prison mental health services should be delivered to develop mental health care, prevention, and intervention programs for incarcerated people to improve suicidal behavior in prison.
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Affiliation(s)
- Setegn Fentahun
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Mesele Wondie
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Mamaru Melkam
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Gebresilassie Tadesse
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Getachew Tesfaw
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
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Favril L, Rich JD, Hard J, Fazel S. Mental and physical health morbidity among people in prisons: an umbrella review. Lancet Public Health 2024; 9:e250-e260. [PMID: 38553144 DOI: 10.1016/s2468-2667(24)00023-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 02/01/2024] [Accepted: 02/06/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND People who experience incarceration are characterised by poor health profiles. Clarification of the disease burden in the prison population can inform service and policy development. We aimed to synthesise and assess the evidence regarding the epidemiology of mental and physical health conditions among people in prisons worldwide. METHODS In this umbrella review, five bibliographic databases (Web of Science, PubMed, PsycINFO, Embase, and Global Health) were systematically searched from inception to identify meta-analyses published up to Oct 31, 2023, which examined the prevalence or incidence of mental and physical health conditions in general prison populations. We excluded meta-analyses that examined health conditions in selected or clinical prison populations. Prevalence data were extracted from published reports and study authors were contacted for additional information. Estimates were synthesised and stratified by sex, age, and country income level. The robustness of the findings was assessed in terms of heterogeneity, excess significance bias, small-study effects, and review quality. The study protocol was pre-registered with PROSPERO, CRD42023404827. FINDINGS Our search of the literature yielded 1909 records eligible for screening. 1736 articles were excluded and 173 full-text reports were examined for eligibility. 144 articles were then excluded due to not meeting inclusion criteria, which resulted in 29 meta-analyses eligible for inclusion. 12 of these were further excluded because they examined the same health condition. We included data from 17 meta-analyses published between 2002 and 2023. In adult men and women combined, the 6-month prevalence was 11·4% (95% CI 9·9-12·8) for major depression, 9·8% (6·8-13·2) for post-traumatic stress disorder, and 3·7% (3·2-4·1) for psychotic illness. On arrival to prison, 23·8% (95% CI 21·0-26·7) of people met diagnostic criteria for alcohol use disorder and 38·9% (31·5-46·2) for drug use disorder. Half of those with major depression or psychotic illness had a comorbid substance use disorder. Infectious diseases were also common; 17·7% (95% CI 15·0-20·7) of people were antibody-positive for hepatitis C virus, with lower estimates (ranging between 2·6% and 5·2%) found for hepatitis B virus, HIV, and tuberculosis. Meta-regression analyses indicated significant differences in prevalence by sex and country income level, albeit not consistent across health conditions. The burden of non-communicable chronic diseases was only examined in adults aged 50 years and older. Overall, the quality of the evidence was limited by high heterogeneity and small-study effects. INTERPRETATION People in prisons have a specific pattern of morbidity that represents an opportunity for public health to address. In particular, integrating prison health within the national public health system, adequately resourcing primary care and mental health services, and improving linkage with post-release health services could affect public health and safety. Population-based longitudinal studies are needed to clarify the extent to which incarceration affects health. FUNDING Research Foundation-Flanders, Wellcome Trust, National Institutes of Health.
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Affiliation(s)
- Louis Favril
- Institute for International Research on Criminal Policy, Faculty of Law and Criminology, Ghent University, Ghent, Belgium
| | - Josiah D Rich
- Warren Alpert Medical School, Brown University, Providence, RI, USA
| | | | - Seena Fazel
- Department of Psychiatry, University of Oxford, Oxford, UK; Oxford Health NHS Foundation Trust, Oxford, UK.
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Eck M, Da Costa J, Wathelet M, Beunas C, d'Ovidio K, Moncany AH, Thomas P, Fovet T. [Prevalence of mental disorders in French prisons: A systematic review]. L'ENCEPHALE 2024:S0013-7006(24)00018-6. [PMID: 38378405 DOI: 10.1016/j.encep.2023.11.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 11/20/2023] [Accepted: 11/24/2023] [Indexed: 02/22/2024]
Abstract
INTRODUCTION The prevalence of psychiatric disorders among prisoners remains a major public health issue worldwide. In France, despite the increasing number of persons who are incarcerated (+30% between 1992 and 2002 with a 120% prison overcrowding), and a historical concern about the mental health of persons in detention and its management, no systematic review has been published on this subject. The aim of this article is to present the results of a systematic review of the literature on the prevalence of psychiatric disorders in French prisons. METHOD The reporting of this systematic review conforms to the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) checklist. We searched the PubMed and Web of Science databases. We used combinations of keywords relating to prison (prison*, jail*, inmate*), to psychiatry ("mental health", psychiatr*), and to France (France, French). This work was completed with a search through the digital libraries of the École des Hautes Études en Santé Publique (EHESP) and of the Système Universitaire de Documentation (Sudoc) to obtain data from academic works and the gray literature. References cited in studies included in this review were also examined. All references published up to September 2022, written in English or French, presenting the results of original quantitative studies on the prevalence of psychiatric disorders in correctional settings were included. Two researchers independently extracted data from included references according to a pre-established protocol. RESULTS Among 501 records identified, a total of 35 papers based on 24 epidemiological studies met the eligibility criteria for inclusion in this review: 16 were cross-sectional, 7 retrospective and 1 both cross-sectional and retrospective. All papers were published between 1999 and 2022. We found one European study, 5 international studies, 18 regional or local studies. Of these, 21 studies had all-male or mixed gender samples (but when the sample was mixed gender, it was always at least 92% male). Almost half of the studies (n=11) involved a small sample of fewer than 500 persons. Half of the studies involved a sample of recently incarcerated persons: 6 involved a random sample of persons in detention, and 1 involved a sample of people incarcerated for more than 5 years. The last 5 studies focused on persons aged over 50 years and incarcerated for more than one year (n=1), incarcerated for sexual offences (n=2), placed in disciplinary cells (n=1) or in a special wing for radicalized or suspected radicalized individuals (n=1). Nine studies used standardized and validated diagnostic tools. According to the 4 studies involving representative samples and using standardized and validated diagnostic tools, the prevalence of the following psychiatric disorders was: 29.4-44.4% for anxiety disorders, 5-14.2% for PTSD, 28-31.2% for mood disorders, 6.9-17% for psychotic disorders, 32% for personality disorders and 11% for ADHD. CONCLUSION This systematic review of the literature highlights the high prevalence of psychiatric disorders in French prisons. The data collected are in line with international studies. The great methodological heterogeneity of the papers included in this review calls for further rigorous research to better understand the rates of mental disorders in French prisons and to explore their determinants.
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Affiliation(s)
- Marion Eck
- Pôle de psychiatrie légale et de conduites addictives en milieu pénitentiaire, centre hospitalier Gérard Marchant, 31057 Toulouse, France; Inserm, U1172 - Lille neuroscience & cognition, université de Lille, 59000 Lille, France.
| | - Julien Da Costa
- Pôle de psychiatrie légale et de conduites addictives en milieu pénitentiaire, centre hospitalier Gérard Marchant, 31057 Toulouse, France
| | - Marielle Wathelet
- Pôle de psychiatrie, médecine légale et médecine en milieu pénitentiaire, CHU de Lille, 59000 Lille, France; Fédération régionale de recherche en psychiatrie et santé mentale Hauts-de-France (F2RSM Psy), Saint-André-lez-Lille, France
| | - Clément Beunas
- Fédération régionale de recherche en psychiatrie et santé mentale Hauts-de-France (F2RSM Psy), Saint-André-lez-Lille, France
| | - Kévin d'Ovidio
- Fédération régionale de recherche en psychiatrie et santé mentale Hauts-de-France (F2RSM Psy), Saint-André-lez-Lille, France
| | - Anne-Hélène Moncany
- Pôle de psychiatrie légale et de conduites addictives en milieu pénitentiaire, centre hospitalier Gérard Marchant, 31057 Toulouse, France
| | - Pierre Thomas
- Inserm, U1172 - Lille neuroscience & cognition, université de Lille, 59000 Lille, France; Pôle de psychiatrie, médecine légale et médecine en milieu pénitentiaire, CHU de Lille, 59000 Lille, France
| | - Thomas Fovet
- Inserm, U1172 - Lille neuroscience & cognition, université de Lille, 59000 Lille, France; Pôle de psychiatrie, médecine légale et médecine en milieu pénitentiaire, CHU de Lille, 59000 Lille, France
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11
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Bukten A, Virtanen S, Hesse M, Chang Z, Kvamme TL, Thylstrup B, Tverborgvik T, Skjærvø I, Stavseth MR. The prevalence and comorbidity of mental health and substance use disorders in Scandinavian prisons 2010-2019: a multi-national register study. BMC Psychiatry 2024; 24:95. [PMID: 38317111 PMCID: PMC10840271 DOI: 10.1186/s12888-024-05540-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 01/19/2024] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND Mental health disorders are common among people in prison, but their prevalence in the Scandinavian prison population remain unclear. In this multinational register study, we examined the prevalence of mental health disorders and the comorbidity of substance use disorders (SUDs) with other mental health disorders in this population. Further, we investigated how the prevalence of mental disorders at prison entry had changed in Norway, Denmark, and Sweden over the study period. METHODS The three study cohorts included all individuals, aged 19 or older, whom had been imprisoned in Norway (2010-2019), Denmark (2011-2018), and Sweden (2010-2013). Mental disorders were defined as ICD-10 diagnoses (F-codes) registered in the national patient registers. The study prevalence was estimated based on recorded diagnoses during the entire study follow-up period in each respective country. The one-year prevalence of mental disorders was estimated for each calendar year for individuals entering prison during that year. RESULTS The Scandinavian prison cohorts included 119 507 individuals released 191 549 times during the study period. Across all three countries a high proportion of both women (61.3%-74.4%) and men (49.6%-57.9%) had at least one mental health disorder during the observation period. The most prevalent disorders were SUDs (39.1%-44.0%), depressive disorder (8.1%-17.5%), and stress related disorder (8.8%-17.1%). Women (31.8%-41.1%) had higher levels of mental health and substance use comorbidities compared to men (20.8%-27.6%). The one-year prevalence of any mental health disorder increased over time with a 33% relative increase in Norway, 8% in Denmark, and 10% in Sweden. The proportion of individuals entering prison with a comorbid SUD and other mental disorder had also increased. CONCLUSIONS While the incarceration rate has been decreasing during the past decade in the Scandinavian countries, an increasing proportion of people entering prison have a diagnosed mental health disorder. Our results suggest that prisons should provide adequate treatment and scale up services to accommodate the increasing proportion of people with complex health needs among incarcerated people.
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Affiliation(s)
- Anne Bukten
- Norwegian Centre for Addiction Research, University of Oslo, Kirkeveien 166, Oslo, N-0407, Norway.
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.
| | - Suvi Virtanen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Morten Hesse
- Center for Alcohol and Drug Research, Aarhus University, Aarhus, Denmark
| | - Zheng Chang
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | | | - Birgitte Thylstrup
- Center for Alcohol and Drug Research, Aarhus University, Aarhus, Denmark
| | - Torill Tverborgvik
- Norwegian Centre for Addiction Research, University of Oslo, Kirkeveien 166, Oslo, N-0407, Norway
| | - Ingeborg Skjærvø
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Marianne R Stavseth
- Norwegian Centre for Addiction Research, University of Oslo, Kirkeveien 166, Oslo, N-0407, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
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12
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D'Orta I, Weber K, Herrmann FR, Giannakopoulos P. Women in acute forensic psychiatric care: comparison of clinical, sociodemographic, and detention-related characteristics in pretrial detention, sentence execution, and court-ordered treatment. BMC Psychiatry 2024; 24:94. [PMID: 38308259 PMCID: PMC10835924 DOI: 10.1186/s12888-024-05546-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 01/21/2024] [Indexed: 02/04/2024] Open
Abstract
Compared to men inmates, women display decreased prevalence of severe mental disorder but increased occurrence of substance use disorders (SUD) and higher rates of previous contacts with mental health services. The group of women in detention is highly heterogeneous according to the status of incarceration (pre-trial detention (PTD), sentence execution (SE) and court ordered treatments (COT)). Studies focusing on the comparison of sociodemographic patterns, detention-related and clinical variables between these groups are still lacking. We explored these parameters in 136 women admitted for acute psychiatric care in the sole Geneva forensic unit during a nine year period (2014-2023). Sociodemographic and detention-related data included age, nationality, marital status, presence of children, education attainment, most frequently speaking language, social support, employment before conviction and type of offenses. Clinical variables included the main ICD-10 diagnosis, presence of concomitant SUD, type of personality disorders, presence of suicidal thoughts and attempts at admission, as well as number and mean duration of stays. PTD and SE women had at least 9 years of formal education in 38.9% and 30.3% of cases. Most women in PTD (77.7%), SE (56.6%) and COT (56.2%) groups were Swiss or European citizens. The level of French knowledge was excellent in most of the cases. 43.8% of COT women had at least one child and this percentage is even higher for PTD and SE cases. The employment rate before conviction was also quite high, mainly for PTD and SE (61.1% and 60.6%) and, in a lesser degree, for COT (43.8%) women. Significant social support was present in the vast majority of women without any significant group difference. The distribution of type of offenses did not differ between the three types of detention with a predominance of physical violence, and drug trafficking. The number of stays during the period of reference was significantly higher in COT compared to both SE and PTD women. History of previous inpatient care was also significantly more frequent in COT that SE and PTD women. Adjustment and affective disorders were more often found in SE and PTD cases, these diagnoses were absent in the COT group. In contrast, a main diagnosis of psychotic disorders was found in 62.5% of COT cases compared to only 21.2% in SE and 24.1% in PTD cases. The number of stays, history of inpatient care and diagnosis of psychosis were independent predictors of COT status. In conclusion, the present data reveal the good social integration and emotional support of women needing acute psychiatric care in prison independently of the type of detention. Clinically, women in PTD and SE display more often emotional distress whereas those in COT suffer from acute psychotic symptoms with previous history of psychiatric care and multiple inpatient stays.
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Affiliation(s)
- Isabella D'Orta
- Division of Institutional Measures, Medical Direction, Geneva University Hospitals, Geneva, Switzerland.
- Institute of Global Health, University of Geneva, Geneva, Switzerland.
| | - Kerstin Weber
- Division of Institutional Measures, Medical Direction, Geneva University Hospitals, Geneva, Switzerland
- Department of Psychiatry, University of Geneva, Geneva, Switzerland
| | - François R Herrmann
- Department of Rehabilitation and Geriatrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Panteleimon Giannakopoulos
- Division of Institutional Measures, Medical Direction, Geneva University Hospitals, Geneva, Switzerland
- Department of Psychiatry, University of Geneva, Geneva, Switzerland
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13
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Kent H, Magner-Parsons B, Leckie G, Dulgar T, Lusiandari A, Hogarth L, Williams H, Kirby A. Profiles of vulnerability for suicide and self-harm in UK prisoners: Neurodisability, mood disturbance, substance use, and bullying. PLoS One 2024; 19:e0296078. [PMID: 38170719 PMCID: PMC10763929 DOI: 10.1371/journal.pone.0296078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 11/27/2023] [Indexed: 01/05/2024] Open
Abstract
Screening for vulnerability factors associated with historic suicidality and self-harm on entry to prison is critical to help prisons understand how to allocate extremely limited mental health resources. It has been established that having previous suicide attempts increases odds of future suicidality and self-harm in prison. We utilised administrative screening data from 665 adult male prisoners on entry to a category B prison in Wales, UK, collected using the Do-IT Profiler. This sample represents 16% of all prisoners who entered that prison during a 26-month period. 12% of prisoners reported a history of attempted suicide, 11% reported historic self-harm, and 8% reported a history of both. Historic traumatic brain injury and substance use problems were associated with a 3.3- and 1.9- times increased odds of a historic suicide attempt, respectively, but no significant increased risk of historic self-harm (95% CI: 1.51-6.60 and 1.02-3.50). However, those who were bullied at school had 2.7 times increased odds of reporting a history of self-harm (95% CI: 1.63-6.09). The most salient risk factors associated with both historic suicide and self-harm were higher levels of functional neurodisability (odds ratio 0.6 for a 1 standard deviation change in score, 95% CI: 0.35-0.75), and mood disturbance (odds ratio 2.1 for a 1 standard deviation change in score, 95% CI: 1.26-3.56). Therefore, it could be beneficial for prisons to screen for broader profiles of needs, to better understand how to provide appropriate services to prisoners vulnerable to suicide and self-harm. Multidisciplinary care pathways for prisoner mental health interventions are important, to account for complex multimorbidity. Adaptations may be needed for mental health interventions to be appropriate for, for example, a prisoner with a brain injury. Understanding this broad profile of vulnerability could also contribute to more compassionate responses to suicide and self-harm from prison staff.
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Affiliation(s)
- Hope Kent
- Department of Psychology, Washington Singer Laboratories, University of Exeter, Devon, United Kingdom
| | - Bella Magner-Parsons
- Department of Psychology, Washington Singer Laboratories, University of Exeter, Devon, United Kingdom
| | - George Leckie
- School of Education, University of Bristol, Bristol, United Kingdom
| | - Tuna Dulgar
- Department of Psychology, Washington Singer Laboratories, University of Exeter, Devon, United Kingdom
| | - Anggita Lusiandari
- Department of Psychology, Washington Singer Laboratories, University of Exeter, Devon, United Kingdom
| | - Lee Hogarth
- Department of Psychology, Washington Singer Laboratories, University of Exeter, Devon, United Kingdom
| | - Huw Williams
- Department of Psychology, Washington Singer Laboratories, University of Exeter, Devon, United Kingdom
| | - Amanda Kirby
- Emeritus Professor, School of Education, University of South Wales, Wales, United Kingdom
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Santoriello C, De Rosa C, Rufo C, Romano F, Termoli G, Fiorillo G, Caprio L, Vitolo M, Pagano AM. Suicide Risk Screening and Assessment before and after the COVID-19 Pandemic in New Inmates. Healthcare (Basel) 2024; 12:100. [PMID: 38201006 PMCID: PMC10779268 DOI: 10.3390/healthcare12010100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Revised: 12/26/2023] [Accepted: 12/31/2023] [Indexed: 01/12/2024] Open
Abstract
(1) Background: Suicide is the main cause of death in Italian prisons. The largest number of inmates who killed themselves was recorded during three years of the COVID-19 pandemic. This study aimed to explore psychosocial risk factors for suicide among inmates incarcerated before and after the onset of COVID-19. (2) Methods: At prison reception, inmates underwent clinical interviews and were assessed using the Blaauw Scale and Suicide Assessment Scale. Psychological distress, measured by the Symptom Checklist-90-R, was compared between inmates admitted before and after COVID-19. Regression analyses were run to examine psychosocial vulnerabilities associated with suicidal intent in newly incarcerated individuals at risk of suicide. (3) Results: Among the 2098 newly admitted inmates (93.7% male) aged 18 to 87 years (M = 39.93; SD = 12.04), 1347 met the criteria for suicide risk, and 98 exhibited high suicidal intent. Inmates who entered prison after the onset of COVID-19 were older and had fewer social relationships. They had a higher prevalence of recidivism and substance abuse, along with elevated levels of psychological distress. An increase in perceived loss of control, anergia, obsessive-compulsive symptoms, phobic anxiety, and paranoid ideation emerged as the factors most strongly associated with high suicidal intent. (4) Conclusions: These findings support the value of psychosocial screening in promptly identifying inmates at risk of suicide, enabling the implementation of targeted, multi-professional interventions. Future research should replicate these results, with a focus on longitudinal studies that monitor the same inmates throughout their incarceration period.
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Affiliation(s)
- Carmen Santoriello
- Unità Operativa Semplice Dipartimentale U.O.S.D. Department of Adults and Minors Healthcare, Criminal Area, Local Health Authority of Salerno, 84132 Salerno, Italy
| | | | | | | | | | | | | | | | - Antonio Maria Pagano
- Unità Operativa Semplice Dipartimentale U.O.S.D. Department of Adults and Minors Healthcare, Criminal Area, Local Health Authority of Salerno, 84132 Salerno, Italy
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15
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Zeidler R, Dudeck M, Frank U, Gerlinger G, Hesse D, Muysers J, Pollmächer T, Riedemann C, Sander J, Völlm B, Müller JL. [The situation in the German forensic commitment-Results of a survey by the DGPPN]. DER NERVENARZT 2024; 95:1-8. [PMID: 37943326 PMCID: PMC10810040 DOI: 10.1007/s00115-023-01564-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/15/2023] [Indexed: 11/10/2023]
Abstract
BACKGROUND AND OBJECTIVE In German forensic psychiatry detention under Sections 63 and 64 of the German Penal Code have been repeatedly reformed over the past years; however, despite the most recent amendments to the law on detention, clinics and state authorities warn of insufficient capacities and worrying conditions. Media reports paint a defiant picture. At the same time, there is a lack of valid data that would allow an objective description of the situation in forensic psychiatry. Against this background the management of institutions in Germany has been surveyed. MATERIAL AND METHODS The survey was conducted as an online survey and sent to all 78 forensic hospitals in Germany. The survey covered topics such as structural data of the facilities, the occupancy and staffing situation, incidents, support from supervisory authorities and funding agencies, and patient characteristics. The results are presented descriptively. RESULTS Of the 78 facilities contacted, 45 (approximately 60%) participated at least partially in the survey. Many of the clinics (68.5%) complained of significant overcrowding. A clear lack of staff and rooms was reported, at the same time it was stated that patients do not receive adequate treatment. Approximately 1 in 5 patients have a length of stay for more than 10 years and one third of the clinics reported an increasing number of physical assaults by patients. CONCLUSION This overview shows that the forensic psychiatric hospitals are in very different but generally strained situations. A significant number of clinics are under great pressure. Financial, structural, spatial and personnel resources were described as insufficient to properly and professionally fulfill the legal mandate. The treatment standards presented by the DGPPN in 2017 are not met in many clinics.
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Affiliation(s)
- Robert Zeidler
- Deutsche Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik und Nervenheilkunde e. V., Berlin, Deutschland
| | - Manuela Dudeck
- Klinik für Forensische Psychiatrie und Psychotherapie der Universität Ulm am BKH Günzburg, Ulm, Deutschland
| | - Udo Frank
- ZfP Südwürttemberg, Ravensburg-Weissenau, Deutschland
| | - Gabriel Gerlinger
- Deutsche Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik und Nervenheilkunde e. V., Berlin, Deutschland
| | - Dirk Hesse
- Maßregelvollzugszentrum Niedersachsen, Moringen, Deutschland
| | | | - Thomas Pollmächer
- Deutsche Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik und Nervenheilkunde e. V., Berlin, Deutschland
- Zentrum für psychische Gesundheit, Klinikum Ingolstadt, Ingolstadt, Deutschland
| | | | - Julia Sander
- Deutsche Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik und Nervenheilkunde e. V., Berlin, Deutschland
| | - Birgit Völlm
- Klinik für Forensische Psychiatrie, Zentrum für Nervenheilkunde, Universitätsmedizin Rostock, Rostock, Deutschland
| | - Jürgen L Müller
- Deutsche Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik und Nervenheilkunde e. V., Berlin, Deutschland.
- Klinik für Forensische Psychiatrie und Psychotherapie, Asklepios Fachklinikum Göttingen, Universitätsmedizin Göttingen, Rosdorfer Weg 70, 37081, Göttingen, Deutschland.
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Lewis C, Fedock G, Garthe R, Lee C. Racial Differences in Suicidal Behaviors and Post-Suicide Attempt Treatment: a Latent Class Analysis of Incarcerated Men's Experiences. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01826-9. [PMID: 37938433 DOI: 10.1007/s40615-023-01826-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 09/06/2023] [Accepted: 10/03/2023] [Indexed: 11/09/2023]
Abstract
Community-based research has found racial differences in suicide attempts for Black and White men and in how men are treated after a suicide attempt; however, prison-based research has largely not explored such differences. This study examined racial differences in the circumstances of incarcerated men's suicide attempts and investigated health care disparities in staff responses to these suicide attempts. With administrative data from three state prisons over a 5-year period, we conducted a latent class analysis to explore patterns of suicide attempts for 207 incarcerated men. We examined race as a predictor of class membership. Black men were more likely than White men to use a method of hanging/suffocation for attempting suicide, and they were also commonly subjected to segregation when they attempted suicide. Black men were less likely to receive health care post-attempt than White men. Given the findings of this study, several key researches, practices, and policy directions are needed to prevent suicide and promote the health and well-being of incarcerated men, particularly incarcerated Black men.
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Affiliation(s)
- Cashell Lewis
- Crown Family School of Social Work, Policy, and Practice, University of Chicago, 969 E. 60th Street, Chicago, IL, 60637, USA.
| | - Gina Fedock
- Crown Family School of Social Work, Policy, and Practice, University of Chicago, 969 E. 60th Street, Chicago, IL, 60637, USA
| | - Rachel Garthe
- School of Social Work, University of Illinois Urbana-Champaign, Champaign, IL, USA
| | - Carol Lee
- Addiction Center, University of Michigan, Ann Arbor, MI, USA
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Crole-Rees C, Kalebic N, Tomlin J, Forrester A. Can prisons be trauma-informed? Reflections on the development of a trauma-informed approach. J Forensic Leg Med 2023; 100:102609. [PMID: 37984320 DOI: 10.1016/j.jflm.2023.102609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 09/29/2023] [Accepted: 10/21/2023] [Indexed: 11/22/2023]
Affiliation(s)
- Clare Crole-Rees
- Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Hadyn Ellis Building, Maindy Road, Cathays, Cardiff, CF24 4HQ, UK; Oxford Health NHS Foundation Trust, UK.
| | - Natasha Kalebic
- Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Hadyn Ellis Building, Maindy Road, Cathays, Cardiff, CF24 4HQ, UK
| | - Jack Tomlin
- School of Law and Criminology, University of Greenwich, London, UK
| | - Andrew Forrester
- Forensic Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Haydn Ellis Building, Maindy Road, Cathays, Cardiff, CF24 4HQ, UK
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Vorstenbosch E, Rodríguez-Liron A, Vicens-Pons E, Félez-Nóbrega M, Escuder-Romeva G. Suicide risk in male incarcerated individuals in Spain: clinical, criminological and prison-related correlates. BMC Psychol 2023; 11:282. [PMID: 37735464 PMCID: PMC10514969 DOI: 10.1186/s40359-023-01315-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 09/06/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND Prison suicide is a complex phenomenon that may be influenced by individual, clinical, social and environmental factors. In Spain, few studies have explored the relationship with institutional, prison-related variables. The aim of this study is to examine correlates of suicide in a sample of male incarcerated individuals from 5 Spanish penitentiary centers. METHODS This present study entails a secondary data analysis, using data from the Prevalence of mental disorders in prisons study. This is a cross-sectional multicenter study conducted in 2007-2008 across 5 penitentiary centers in Spain. The Spanish version of the Plutchik suicide risk scale was used to assess the risk of suicide (those scoring ≥ 6 were considered to be at risk of suicide). Sociodemographic, clinical, criminological and prison-related data were collected via face-to face interviews and criminological data were confirmed using penitentiary records. RESULTS The final sample included 707 male incarcerated individuals (mean age 36.79 years ± 9.90 years). Several significant correlates associated with higher risk of suicide were identified including criminological factors (having committed a violent offense, being a recidivist), clinical factors (family history of mental disorders, the presence of mental disorders, having physical conditions, contact with a mental health specialist, medication treatment in the last 12 months), and prison-related determinants (workshop/training course participation) was significantly associated with lower suicide risk. CONCLUSIONS Several correlates within a comprehensive range of sociodemographic, criminological, clinical and prison-related variables were identified. This information is primordial for preventing suicide and reducing the existing risk. The findings may contribute to developing effective suicide prevention programs within Spanish prison services. Importantly, future research must continue to investigate the nature of suicidal outcomes among incarcerated individuals.
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Affiliation(s)
- Ellen Vorstenbosch
- Parc Sanitari Sant Joan de Déu, Research, Teaching and Innovation Unit, C/ Dr. Antoni Pujadas 42, 08830, Sant Boi de Llobregat, Spain.
- Instituto de Salud Carlos III, Centre for Biomedical Research On Mental Health (CIBERSAM), C/ Monforte de Lemos 3-5, 28029, Madrid, Spain.
| | - Ariadna Rodríguez-Liron
- Parc Sanitari Sant Joan de Déu, Research, Teaching and Innovation Unit, C/ Dr. Antoni Pujadas 42, 08830, Sant Boi de Llobregat, Spain
| | - Enric Vicens-Pons
- Parc Sanitari Sant Joan de Déu, Research, Teaching and Innovation Unit, C/ Dr. Antoni Pujadas 42, 08830, Sant Boi de Llobregat, Spain
| | - Mireia Félez-Nóbrega
- Parc Sanitari Sant Joan de Déu, Research, Teaching and Innovation Unit, C/ Dr. Antoni Pujadas 42, 08830, Sant Boi de Llobregat, Spain
- Instituto de Salud Carlos III, Centre for Biomedical Research On Mental Health (CIBERSAM), C/ Monforte de Lemos 3-5, 28029, Madrid, Spain
| | - Gemma Escuder-Romeva
- Parc Sanitari Sant Joan de Déu, Research, Teaching and Innovation Unit, C/ Dr. Antoni Pujadas 42, 08830, Sant Boi de Llobregat, Spain
- Parc Sanitari Sant Joan de Déu, Penitentiary Psychiatric Hospitalization Unit of Catalonia, Carretera de Martorell a Capellades, Km 23, 08635, Sant Esteve Sesrovires, Spain
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Mancinelli Y. [The benefits of implementing IPA psychiatry and mental health in prisons]. Soins Psychiatr 2023; 44:40-43. [PMID: 37743091 DOI: 10.1016/j.spsy.2023.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
Supporting people placed under house arrest is a contemporary challenge. Between popular demand for risk control, judicial demand for recidivism prevention and hospital prerogatives, the articulation between care providers is often perilous. The advanced practice nurse plays a key role in the transition from inside to outside.
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Affiliation(s)
- Yann Mancinelli
- Centre psychothérapique de Nancy, 1 rue du Docteur-Archambault, 54520 Laxou, France.
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20
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Cloud DH, Williams B, Haardörfer R, Brinkley-Rubinstein L, Cooper HLF. Extreme Heat and Suicide Watch Incidents Among Incarcerated Men. JAMA Netw Open 2023; 6:e2328380. [PMID: 37566416 PMCID: PMC10422184 DOI: 10.1001/jamanetworkopen.2023.28380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 06/29/2023] [Indexed: 08/12/2023] Open
Abstract
Importance Extreme heat poses a distinct risk to the 2.1 million incarcerated people in the United States, who have disparately high rates of behavioral health conditions. Suicide is a leading cause of death among people in prisons. Objective To examine associations of extreme heat, solitary confinement, and an indicator of suicidal behaviors among incarcerated men in a Deep South US prison system. Design, Setting, and Participants This longitudinal case series panel study included adult men in prisons in Louisiana, a state with one of the largest prison systems in the United States that has been engaged in litigation due to lack of air conditioning and extreme heat. The unit of analysis was prison facility-days. A facility-level data set was created by merging administrative data files, which included demographic characteristics, health classification, housing location and movement, disciplinary records, and involvement in suicide-watch incidents for all incarcerated men in Louisiana during the observation period. Individual-level variables were aggregated to facility-days to merge in daily maximum heat index data from the US Local Climatological Data, which were linked to the zip codes of prisons. The observation period was January 1, 2015, to December 31, 2017. Data set construction occurred from August 2020 to September 2022, and analysis was conducted from December 2022 to February 2023. Exposure The focal exposure was extreme heat days. Daily maximum heat index data were categorized into 6 bins (<30 °F, 30-39 °F, 40-49 °F, 50-59 °F, 70-79 °F, and ≥80 °F) and as an indicator for any facility-day where the maximum heat index exceeded the 90th percentile of heat indices for total days in observation period. Conditional fixed-effects negative binomial regression models were used to calculate incident rate ratios to test associations between extreme heat and suicide watch incidents, while controlling for covariates. Main Outcomes and Measures The focal outcome was daily count of suicide watch incidents that were recorded in a carceral system database. Covariates included daily percentages of incarcerated persons at each prison with serious mental illness diagnosis, daily rate of solitary confinement, and total facility population. Results The sample of 6 state-operated prisons provided 6576 facility-days for the analysis. Results suggest a dose-responsive association between extreme heat and daily counts of suicide-watch incidents; compared with days with temperatures between 60 and 69 °F, the rate of daily suicide incidents increased by 29% when the heat index reached the level of caution (ie, 80-89 °F) and by 36% when reaching extreme caution (90-103 °F) (80-89 °F: incidence rate ratio [IRR], 1.29; 95% CI, 1.17-1.43; P < .001; 90-103 °F: IRR, 1.36; 95% CI, 1.15-1.61; P < .001). Compared with other days, those with the extreme heat indicator were significantly associated with a 30% increase in the incident rate of daily suicide-watch incidents (IRR, 1.30; 95% CI, 1.18-1.45; P < .001). Conclusions and Relevance Findings suggest an association between extreme heat and an indicator of suicidality among an incarcerated sample, contribute to an emerging literature exploring linkages between climatological events and health outcomes in prisons, and may have implications for legal interventions and advocacy seeking to abate heat-induced morbidity and mortality in carceral contexts.
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Affiliation(s)
- David H. Cloud
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, Georgia
- Amend at the School of Medicine, University of California, San Francisco School of Medicine
| | - Brie Williams
- Amend at the School of Medicine, University of California, San Francisco School of Medicine
| | - Regine Haardörfer
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | | | - Hannah L. F. Cooper
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, Georgia
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21
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Kamat SM, Gansa W, D'Ovidio T, Patel S, Bai H, Akiyama MJ, Appel JM. Clinician Perspectives for Mental Health Delivery Following COVID-19 in Carceral Settings: A Pilot Study. Psychiatr Q 2023:10.1007/s11126-023-10028-9. [PMID: 37166616 PMCID: PMC10172725 DOI: 10.1007/s11126-023-10028-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/05/2023] [Indexed: 05/12/2023]
Abstract
We aimed to understand clinician perspectives on mental healthcare delivery during COVID-19 and the utility of tele-mental health services in carceral settings. A survey was administered in November 2022 through the American College of Correctional Physicians listserv. A nationwide sample of 55 respondents included 78.2% male (n = 43) and 21.8% female (n = 12), 49.1% active clinicians (n = 27) and 50.9% medical directors (n = 28), with a median of 12 and mean of 14.5 years working in carceral settings. Most agreed that mental telehealth services could serve as a stopgap amid infection prevention measures and resource-limited settings with an increasing role moving forward (80.0%, n = 44) but may not be sufficient to replace in-person services completely. Access to mental healthcare is vital in helping achieve optimal health during incarceration. Most clinicians in a nationwide survey report an essential role of mental telehealth in the future, although they vary in beliefs on the present implementation. Future efforts should further identify facilitators and barriers and bolster delivery models, particularly via e-health.
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Affiliation(s)
- Samir M Kamat
- Department of Medical Education, Icahn School of Medicine, New York, NY, 10029, USA.
| | - William Gansa
- Department of Medical Education, Icahn School of Medicine, New York, NY, 10029, USA
| | - Tyler D'Ovidio
- Department of Medical Education, Icahn School of Medicine, New York, NY, 10029, USA
| | | | - Halbert Bai
- Department of Medical Education, Icahn School of Medicine, New York, NY, 10029, USA
| | - Matthew J Akiyama
- Divisions of General Internal Medicine and Infectious Diseases, Albert Einstein College of Medicine, Bronx, NY, 10461, USA
| | - Jacob M Appel
- Department of Medical Education, Icahn School of Medicine, New York, NY, 10029, USA
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22
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McTernan N, Griffin E, Cully G, Kelly E, Hume S, Corcoran P. The incidence and profile of self-harm among prisoners: findings from the Self-Harm Assessment and Data Analysis Project 2017-2019. Int J Prison Health 2023; 19:565-577. [PMID: 37125411 DOI: 10.1108/ijph-02-2023-0012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
PURPOSE Internationally, rates of suicide and lifetime self-harm are higher in prisoners compared to the general population. This study aims to identify specific characteristics of self-harming behaviour and to establish a profile of prisoners who engage in self-harm. DESIGN/METHODOLOGY/APPROACH Data from the Self-Harm Assessment and Data Analysis Project (SADA) on self-harm episodes in prisons in the Republic of Ireland during 2017-2019 was used. Annual rates per 1,000 were calculated by age and gender. FINDINGS The rate of self-harm between 2017 and 2019 was 31 per 1,000 prisoners for men and six times higher at 184 per 1,000 prisoners for women. The rate of self-harm was twice as high among prisoners on remand than sentenced prisoners (60.5 versus 31.3 per 1,000). The highest rates of self-harm among sentenced prisoners were observed among 18-29-year-old men (45 per 1,000) and women (125 per 1,000). The rate of self-harm was higher among women prisoners in all age groups. Contributory factors associated with self-harm were mainly related to mental health but also linked to a prisoner's environment and relationships. PRACTICAL IMPLICATIONS There is a need to ensure access to timely and suitable mental health services, including both appropriate referral and provision of evidence-based mental health interventions to address the needs of these cohorts. ORIGINALITY/VALUE To the best of the authors' knowledge, this is the first national study to systematically examine incidence and patterns of self-harm among the prison population in Ireland. The recording of severity/intent of each episode is novel when assessing self-harm among the prison population.
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Affiliation(s)
- Niall McTernan
- National Suicide Research Foundation, University College Cork, Cork, Ireland
| | - Eve Griffin
- National Suicide Research Foundation, University College Cork, Cork, Ireland and School of Public Health, University College Cork, Cork, Ireland
| | - Grace Cully
- National Suicide Research Foundation, University College Cork, Cork, Ireland and School of Public Health, University College Cork, Cork, Ireland
| | | | | | - Paul Corcoran
- National Suicide Research Foundation, University College Cork, Cork, Ireland and School of Public Health, University College Cork, Cork, Ireland
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23
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Hemming L, Bhatti P, Haddock G, Shaw J, Pratt D. What emotions do male prisoners experience in the lead-up to suicide and violence? A participatory visual method study. THE JOURNAL OF FORENSIC PSYCHIATRY & PSYCHOLOGY 2023; 34:193-215. [PMID: 37346969 PMCID: PMC10281511 DOI: 10.1080/14789949.2023.2199717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 04/02/2023] [Indexed: 06/23/2023]
Abstract
Rates of suicide and violence are higher amongst male prisoners than the general population. This study aimed to explore the emotional experiences of male prisoners in the distal and immediate lead-up to acts of suicide and violence. Nine male prisoners created drawings of their emotions in the lead-up to an act of suicide and/or violence. Accompanying verbal interview data was collected to explore the narrative of these drawings. Polytextual thematic analysis was conducted on both the visual and audio data. Three themes were found. 'The outside picture' depicted the emotions that male prisoners exhibited externally. 'The inside picture' illustrated the internal emotions felt by male prisoners which were often complex and abstract. 'The complexity of the picture' denotes the complicated relationship between emotions and suicide/violence. Male prisoners experience a range of emotions in the lead up to acts of suicide and violence, with a similar set of emotions being experienced immediately prior to both suicide and violence. This study has illustrated the benefits of using a novel and creative methodology, and has demonstrated that future research with male prisoners could benefit from adopting a participatory visual methodology.
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Affiliation(s)
- Laura Hemming
- Division of Psychology and Mental Health, School of Health Sciences, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
| | - Peer Bhatti
- Division of Psychology and Mental Health, School of Health Sciences, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
| | - Gillian Haddock
- Division of Psychology and Mental Health, School of Health Sciences, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Sciences Centre, Manchester, UK
| | - Jennifer Shaw
- Division of Psychology and Mental Health, School of Health Sciences, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Sciences Centre, Manchester, UK
| | - Daniel Pratt
- Division of Psychology and Mental Health, School of Health Sciences, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Sciences Centre, Manchester, UK
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24
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Alcántara-Jiménez M, Torres-Parra I, Guillén-Riquelme A, Quevedo-Blasco R. Los Factores Psicosociales en el Suicidio de Presos en Prisiones Europeas: una Revisión Sistemática y Metaanálisis. ANUARIO DE PSICOLOGÍA JURÍDICA 2023. [DOI: 10.5093/apj2022a13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
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25
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Cloud DH, Williams B, Haardöerfer R, Hosbey JT, Cooper HL. Self-injury and the embodiment of solitary confinement among adult men in Louisiana prisons. SSM Popul Health 2023; 22:101354. [PMID: 36865676 PMCID: PMC9971521 DOI: 10.1016/j.ssmph.2023.101354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 01/17/2023] [Accepted: 01/31/2023] [Indexed: 02/04/2023] Open
Abstract
Solitary confinement is a harrowing human rights and public health problem that is currently inflicted as a routine punishment for a litany of prison rule violations, a reactionary tactic to quell resistance to prison conditions, and as a destination of last resort for people serious mental illnesses (SMI) who are especially vulnerable to its harms. An extensive body of research has documented clusters of psychiatric symptoms-emotional distress, cognitive deficits, social withdrawal, anxiety, paranoia, sleeplessness, and hallucinations-linked to solitary confinement that often manifest in decompensating behaviors, which include self-injury and suicide. This study summarizes the historical evolution of solitary confinement, recaps its linkages to self-injury and suicidality, and offers a theoretical framework grounded in ecosocial theory, and supplemented with concepts from theories of dehumanization and carceral geography. Findings bolster extant evidence on the harms of solitary confinement by focusing on whether and how exertions of power by prison staff to deploy mechanisms of dehumanization-as a pathway between SMI and self-injury among a cross section of adult men (n = 517) exposed to solitary confinement in Louisiana prisons in 2017. Findings reinforce the need for structural interventions that diffuse forms of carceral power and practices that continue to subject people to isolation, dehumanization, and violence.
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Affiliation(s)
- David H. Cloud
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, USA,Amend, Center for Vulnerable Populations, University of California San Francisco, School of Medicine, USA,Corresponding author. Emory University, Rollins School of Public Health, 1518 Clifton Rd, Atlanta, GA, 30322, USA.
| | - Brie Williams
- Amend, Center for Vulnerable Populations, University of California San Francisco, School of Medicine, USA
| | - Regine Haardöerfer
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, USA
| | - Justin T. Hosbey
- College of Environmental Design, University of California, Berkeley, USA
| | - Hannah L.F. Cooper
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, USA
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26
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Soins psychiatriques en détention : quelles spécificités ? ANNALES MÉDICO-PSYCHOLOGIQUES, REVUE PSYCHIATRIQUE 2023. [DOI: 10.1016/j.amp.2022.11.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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27
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Janca E, Keen C, Willoughby M, Borschmann R, Sutherland G, Kwon S, Kinner SA. Sex differences in suicide, suicidal ideation, and self-harm after release from incarceration: a systematic review and meta-analysis. Soc Psychiatry Psychiatr Epidemiol 2023; 58:355-371. [PMID: 36462041 PMCID: PMC9971066 DOI: 10.1007/s00127-022-02390-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 11/14/2022] [Indexed: 12/04/2022]
Abstract
PURPOSE People released from incarceration are at increased risk of suicide compared to the general population. We aimed to synthesise evidence on the incidence of and sex differences in suicide, suicidal ideation, and self-harm after release from incarceration. METHODS We searched MEDLINE, EMBASE, PsycINFO, Web of Science and PubMed between 1 January 1970 and 14 October 2021 for suicide, suicidal ideation, and self-harm after release from incarceration (PROSPERO registration: CRD42020208885). We calculated pooled crude mortality rates (CMRs) and standardised mortality ratios (SMRs) for suicide, overall and by sex, using random-effects models. We calculated a pooled incidence rate ratio (IRR) comparing rates of suicide by sex. RESULTS Twenty-nine studies were included. The pooled suicide CMR per 100,000 person years was 114.5 (95%CI 97.0, 132.0, I2 = 99.2%) for non-sex stratified samples, 139.5 (95% CI 91.3, 187.8, I2 = 88.6%) for women, and 121.8 (95% CI 82.4, 161.2, I2 = 99.1%) for men. The suicide SMR was 7.4 (95% CI 5.4, 9.4, I2 = 98.3%) for non-sex stratified samples, 14.9 for women (95% CI 6.7, 23.1, I2 = 88.3%), and 4.6 for men (95% CI 1.3, 7.8, I2 = 98.8%). The pooled suicide IRR comparing women to men was 1.1 (95% CI 0.9, 1.4, I2 = 82.2%). No studies reporting self-harm or suicidal ideation after incarceration reported sex differences. CONCLUSION People released from incarceration are greater than seven times more likely to die by suicide than the general population. The rate of suicide is higher after release than during incarceration, with the elevation in suicide risk (compared with the general population) three times higher for women than for men. Greater effort to prevent suicide after incarceration, particularly among women, is urgently needed.
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Affiliation(s)
- Emilia Janca
- Curtin School of Population Health, Curtin University, 410 Koorliny Way, Bentley, WA, 6102, Australia. .,Justice Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, VIC, 3053, Australia.
| | - Claire Keen
- Justice Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, VIC 3053 Australia
| | - Melissa Willoughby
- Justice Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, VIC 3053 Australia ,Centre for Adolescent Health, Murdoch Children’s Research Institute, 50 Flemington Road, Parkville, VIC 3052 Australia
| | - Rohan Borschmann
- Justice Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, VIC 3053 Australia ,Centre for Adolescent Health, Murdoch Children’s Research Institute, 50 Flemington Road, Parkville, VIC 3052 Australia ,Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX UK ,Melbourne School of Psychological Sciences, The University of Melbourne, Grattan Street, Parkville, VIC Australia
| | - Georgina Sutherland
- Disability and Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, VIC 3053 Australia
| | - Sohee Kwon
- Justice Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, VIC 3053 Australia
| | - Stuart A. Kinner
- Curtin School of Population Health, Curtin University, 410 Koorliny Way, Bentley, WA 6102 Australia ,Justice Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, VIC 3053 Australia ,Centre for Adolescent Health, Murdoch Children’s Research Institute, 50 Flemington Road, Parkville, VIC 3052 Australia ,Mater Research Institute-UQ, University of Queensland, Mater Hospital, Raymond Terrace, South Brisbane, QLD 4101 Australia ,Griffith Criminology Institute, Griffith University, 176 Messines Ridge Road, Mount Gravatt, QLD 4122 Australia ,School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC 3004 Australia
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28
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Raddi S, Baralla F, D’Argenio A, Traverso S, Sarchiapone M, Marchetti M. Do Homicide Perpetrators Have Higher Rates of Delayed-Suicide Than the Other Offenders? Data from a Sample of the Inmate Population in Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16991. [PMID: 36554869 PMCID: PMC9778990 DOI: 10.3390/ijerph192416991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 12/09/2022] [Accepted: 12/14/2022] [Indexed: 06/17/2023]
Abstract
Homicide-suicide can be defined as homicide followed by the suicide of the perpetrator shortly afterward. In the so-called "homicide-delayed suicide", homicide and suicide occur but within a wide and not strictly defined timeframe. This study analyzes data concerning the suicide of 667 inmates in Italy between 2002 and 2015, considering homicide perpetrators compared to all offenders. The analyses revealed that inmates who had committed homicide were more likely to commit suicide (71% versus 45%; χ2 = 10.952, p = 0.001) and the odds of suicide increase concerning 1.58 times among homicide perpetrators. The time-to-suicide interval after homicide ranges between 0 to 9.125 days (mean = 1.687,9; SD = 2.303,1). Moreover, the intimate-homicide offenders who committed suicide had a significantly shorter survival time after the offense than did the other non-intimate offenders who died by suicide (t test, t = -3.56, df = 90, p = 0.001). The link between homicide and higher suicide risk in homicide perpetrators should be highlighted because of all the homicide offenders passing through the criminal justice system. Superior knowledge about the path of homicide-delayed suicide will be of particular use to professionals in evaluating and treating homicide inmates.
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Affiliation(s)
- Silvia Raddi
- Department of Health Sciences, University of Florence, 50134 Florence, Italy
| | - Francesca Baralla
- Department of Humanities, Social Sciences and Education—SUSeF, University of Molise, 86100 Campobasso, Italy
| | - Alberto D’Argenio
- Department of Neuroscience, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Simona Traverso
- Department of Medical Science, Chirurgical and Neuroscience, University of Siena, 53100 Siena, Italy
| | - Marco Sarchiapone
- Department of Medicine and Health Sciences, University of Molise, 86100 Campobasso, Italy
| | - Marco Marchetti
- Department of Medicine and Health Sciences, University of Molise, 86100 Campobasso, Italy
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Freese RA, Canada KE, Nichols PM, McNamara B. Suicide in prisons: describing trends and staff knowledge and preparedness to address suicide. Int J Prison Health 2022; 19:427-439. [PMID: 36449448 DOI: 10.1108/ijph-02-2022-0011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
PURPOSE Suicide prevention and intervention in prisons is a challenge. Prisons were not designed to be clinical facilities, yet with the growing numbers of people who face mental health challenges in prisons, staff require knowledge and skills to adequately address mental health crises, especially suicide. This study aims to: describe trends in suicide attempts and completions within one state's prison system and measure staff knowledge and preparedness to address suicide. DESIGN/METHODOLOGY/APPROACH This research uses a nonexperimental research design and two data sources. Administrative data from 2000 to 2017 on serious suicide attempts and completions were analyzed, and all correctional staff employed in the state's Department of Corrections were surveyed at one point in time. Univariate and bivariate analyses were conducted. FINDINGS The number of serious suicide attempts trended up but completed suicides decreased. Correctional staff demonstrated high suicide knowledge of risk factors and warning signs of suicide. Staff who viewed a media-based suicide training displayed significantly more knowledge of suicide and perceived greater preparedness compared to staff who did not or did not recall viewing the training. ORIGINALITY/VALUE Corrections staff play a key role in preventing suicides in prison. Innovative intervention is needed to increase suicide awareness, improve communication and enhance prevention skills.
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Affiliation(s)
- Rebekah A Freese
- School of Social Work, University of Missouri, Columbia, Missouri, USA
| | - Kelli E Canada
- School of Social Work, University of Missouri, Columbia, Missouri, USA
| | | | - Brianna McNamara
- School of Social Work, University of Missouri, Columbia, Missouri, USA
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30
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Alexithymia and depressive symptoms mediated the relationship between childhood trauma and suicidal risk in Chinese male prisoners. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03975-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Zeveleva O, Nazif-Munoz JI. COVID-19 and European carcerality: Do national prison policies converge when faced with a pandemic? PUNISHMENT & SOCIETY 2022; 24:642-666. [PMID: 36199276 PMCID: PMC9464929 DOI: 10.1177/14624745211002011] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The article analyses an original dataset on policies adopted in 47 European
countries between December 2019 and June 2020 to prevent coronavirus from
spreading to prisons, applying event-history analysis. We answer two questions:
1) Do European countries adopt similar policies when tackling the COVID-19
pandemic in prisons? 2) What factors are associated with prison policy
convergence or divergence? We analyze two policies we identified as common
responses across prisons around the world: limitations on visitation rights for
prisoners, and early releases of prisoners. We found that all states in our
sample implemented bans on visits, showing policy convergence. Fewer countries
(16) opted for early releases. Compared to the banning of visitation, early
releases took longer to enact. We found that countries with prison overcrowding
problems were quicker to release or pardon prisoners. When prisons were not
overcrowded, countries with higher proportions of local nationals in their
prisons were much faster to limit visits relative to prisons in which the
foreign population was high. This research broadens our comparative
understanding of European carcerality by moving the comparative line further
East, taking into account multi-level governance of penality, and analyzing
variables that emphasize the ‘society’ element of the ‘punishment and society’
nexus.
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Affiliation(s)
- Olga Zeveleva
- University of Helsinki, Finland
- Université de Sherbrooke, Canada; Harvard University, USA
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Kurdyak P, Friesen EL, Young JT, Borschmann R, Iqbal J, Huang A, Kouyoumdjian F. Prevalence of Mental Health and Addiction Service use Prior to and During Incarceration in Provincial Jails in Ontario, Canada: A Retrospective Cohort Study. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2022; 67:690-700. [PMID: 34792415 PMCID: PMC9449135 DOI: 10.1177/07067437211055414] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Individuals with mental illness and addiction are overrepresented in prisons. Few studies have assessed mental health and addiction (MHA)-related service use among individuals experiencing incarceration using health administrative data and most focus on service use after prison release. The objective of this study was to determine the prevalence of MHA-related service use in the 5 years prior to and during incarceration. METHODS We used linked correctional and administrative health data for people released from Ontario provincial jails in 2010. MHA-related service use in the 5 years prior to the index incarceration was categorized hierarchically into four mutually exclusive categories based on the type of service use: psychiatric hospitalization, MHA-related emergency department (ED) visit, MHA-related outpatient visit (from psychiatrist or primary care physician), and no MHA-related service use. Demographic, diagnostic, and incarceration characteristics were compared across the four service use categories. MHA-related service use during the index incarceration was assessed by category and length of incarceration. RESULTS A total of 48,917 individuals were included. Prior to incarceration, 6,116 (12.5%) had a psychiatric hospitalization, 8,837 (18.1%) had an MHA-related ED visit, and 15,866 (32.4%) had an MHA-related outpatient visit. Of the individuals with any MHA-related service prior to incarceration, 60.4% did not receive outpatient care from a psychiatrist prior to incarceration and 65.6% did not receive MHA-related care during incarceration. CONCLUSION Despite a high prevalence of mental illness and addiction among people experiencing incarceration, access to and use of MHA-related care prior to and during incarceration is poor. Increasing the accessibility and use of MHA-related services throughout the criminal justice pathway is warranted.
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Affiliation(s)
- Paul Kurdyak
- 7978Centre for Addiction and Mental Health, Toronto, ON, Canada.,ICES, Toronto, ON, Canada.,Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Erik L Friesen
- 7978Centre for Addiction and Mental Health, Toronto, ON, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Jesse T Young
- Justice Health Unit, Centre for Health Equity, 50066Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia.,School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia.,National Drug Research Institute, Curtin University, Perth, Western Australia, Australia
| | - Rohan Borschmann
- Justice Health Unit, Centre for Health Equity, 50066Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Department of Psychiatry; Warneford Hospital, University of Oxford, Oxford OX3 7JX, UK.,Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | | | | | - Fiona Kouyoumdjian
- ICES, Toronto, ON, Canada.,Department of Family Medicine, 3710McMaster University, Hamilton, ON, Canada
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Tallent J, Phillips J, Coren E. PROTOCOL: Arts-based interventions for offenders in secure criminal justice settings to improve rehabilitation outcomes: An evidence and gap map. CAMPBELL SYSTEMATIC REVIEWS 2022; 18:e1255. [PMID: 36909891 PMCID: PMC9399450 DOI: 10.1002/cl2.1255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
This is the protocol for a Campbell review. The objective of this evidence and gap map is to presents the existing research on the impact of arts-based interventions in secure criminal justice settings (SCJS) that aim to improve desistance outcomes for offenders. It will indicate the quality of available evidence, highlighting the gaps and informing future research priorities. Importantly, it will also identify where the evidence could be systematically reviewed. This would clearly produce a more comprehensive understanding of the available knowledge and an opportunity to move forward in a more direct and focussed way, with the potential to influence research, intervention development, and inform funding decisions.
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Affiliation(s)
- Jacqueline Tallent
- Sidney De Haan Research Centre for Arts and HealthCanterbury Christ Church UniversityCanterburyKentUK
| | - Jes Phillips
- Sidney De Haan Research Centre for Arts and HealthCanterbury Christ Church UniversityCanterburyKentUK
| | - Esther Coren
- Sidney De Haan Research Centre for Arts and HealthCanterbury Christ Church UniversityCanterburyKentUK
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Stijelja S, Mishara BL. Preventing suicidal and self-Injurious behavior in correctional facilities: A systematic literature review and meta-analysis. EClinicalMedicine 2022; 51:101560. [PMID: 35898320 PMCID: PMC9309412 DOI: 10.1016/j.eclinm.2022.101560] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 06/25/2022] [Accepted: 06/27/2022] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND Rates of suicide and self-harm are elevated in carceral institutions. Inmates are a vulnerable group since they are exposed to multiple risk factors. This paper critically reviews empirical research on programs to prevent suicidal and self-harmful behaviors in correctional facilities and summarizes effect sizes across studies. METHODS We searched PsychINFO, PubMed, IEEEXPLORE and the CRISE Documentation Centre Database to identify relevant articles published before June 2022. Inclusion criteria were: peer-reviewed and with outcome data on effectiveness of prevention activities. Two reviewers independently assessed 905 articles to determine inclusion eligibility. Quality was assessed by two independent reviewers using the Quality Assessment Tool for Quantitative Studies. Meta-analyses using random-effect models were used to pool effect sizes for each outcome. This review was conducted in accordance with PRISMA guidelines. FINDINGS Twenty-four of the 905 articles, published between 1980 and 2022, were included. Studies were frequently conducted in the United States (n=13; 54%) and used varying study designs; most frequently pre-post with no control group (n=9; 38%). Sample sizes and interventions varied considerably. Most were of moderate quality (n=21; 88%). On average, prevention programs in correctional facilities were effective in decreasing suicide deaths (pooled rate ratio of 0·35 [95% CI 0·23 to 0·55; p<0·001]; I2=68·01%), incidents of self-harm (pooled Hedges'g of -0·54 (95% CI: -1·03 to -0·05; p=0·031]; I2=81·34%), and suicidal ideation (pooled Hedges'g of -0·39 [95% CI: -0·65 to -0·14; p=0·003]; I2=47·09%). INTERPRETATION Prevention activities are effective in reducing suicide death, self-harm and suicidal ideation in correctional settings. Multicomponent programs, which include several preventive activities, seem to be most effective in reducing suicide deaths. Future evaluation studies should control for confounding variables by including control groups, having larger samples and limiting attrition. Standards for suicide prevention in jails and prisons should be included in National suicide prevention strategies. FUNDING None.
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Affiliation(s)
- Stefan Stijelja
- Centre for Research and Intervention on Suicide, Ethical Issues and End of Life Practices, Université du Québec à Montréal, Montreal, Quebec, Canada
| | - Brian L. Mishara
- Department of Psychology, Université du Québec à Montréal, Montreal, Quebec, Canada
- Corresponding author at: CRISE-UQAM, C.P. 8888, Succ. Centre-ville, Montréal, Québec H3C 3P8, Canada.
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Childhood maltreatment and nonsuicidal self-injury among younger Chinese prisoners: the mediating role of self-esteem. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03647-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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36
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Favril L, Shaw J, Fazel S. Prevalence and risk factors for suicide attempts in prison. Clin Psychol Rev 2022; 97:102190. [PMID: 36029609 DOI: 10.1016/j.cpr.2022.102190] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 06/28/2022] [Accepted: 08/03/2022] [Indexed: 11/18/2022]
Abstract
Suicidal behaviour represents a substantial burden of morbidity and mortality in prisons worldwide. We aimed to synthesise the evidence on prevalence and risk factors for suicide attempts during incarceration. In this systematic review and meta-analysis, we searched four bibliographic databases for studies (published up to May 31, 2022) reporting on adults sampled from the general prison population who attempted suicide while incarcerated and an unselected comparison group. A total of 20 studies comprising 19,882 individuals (6.5% women) in 20 countries were eligible for inclusion. The pooled prevalence of suicide attempts during incarceration was 8.6% (95% CI 6.1-11.2) in men and 12.2% (95% CI 7.1-17.2) in women. Across all 36 risk factors studied, the strongest associations were found for suicidal ideation, previous self-harm, and markers of psychiatric morbidity. Prison-related risk factors included solitary confinement, victimisation, and poor social support while incarcerated. Sensitivity analyses indicate that risk factors for near-lethal suicide attempts are similar to those for suicide attempts more generally. In addition to providing a synthesis of previous work, our systematic review highlights several key limitations of the extant literature, which provide directions for future research.
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Affiliation(s)
- Louis Favril
- Faculty of Law and Criminology, Ghent University, Ghent, Belgium.
| | - Jenny Shaw
- Division of Psychology and Mental Health, University of Manchester, Manchester, UK
| | - Seena Fazel
- Department of Psychiatry, University of Oxford, Oxford, UK
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Bukten A, Skjærvø I, Stavseth MR. The association of prison security level with mortality after release from prison: a retrospective national cohort study (2000–16). THE LANCET PUBLIC HEALTH 2022; 7:e583-e592. [DOI: 10.1016/s2468-2667(22)00107-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 04/08/2022] [Accepted: 04/13/2022] [Indexed: 12/01/2022] Open
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Hewson T, Gutridge K, Bernard Z, Kay K, Robinson L. A systematic review and mixed-methods synthesis of the experiences, perceptions and attitudes of prison staff regarding adult prisoners who self-harm. BJPsych Open 2022; 8:e102. [PMID: 35659128 PMCID: PMC9230562 DOI: 10.1192/bjo.2022.70] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Self-harm, including suicide, is common among prisoners. Staff attitudes and perceptions regarding self-harm may affect quality of care and patient safety. AIMS To systematically review the experiences, perceptions and attitudes of staff in adult prisons regarding self-harm. METHOD Systematic searches of EMBASE, Medline, PsycINFO and CINAHL databases were conducted, and supplemented by hand-searching and grey literature review, to identify relevant English-language articles published since the year 2000. Articles were screened by two authors and evaluated with standardised quality appraisal tools. Qualitative data were analysed thematically, whereas quantitative data were narratively synthesised because of high study heterogeneity. RESULTS Two thousand articles were identified, of which 32 were included, involving 6389 participants from five countries. Most studies were moderate (n = 15) or poor (n = 10) quality, and seven were rated as good quality. Staff frequently witnessed self-harm and described multiple perceived risk factors and causes of this. Perceptions that self-harm is 'manipulative' or 'attention-seeking' were associated with hostility toward prisoners and lower quality of care. Perceived barriers to preventing and managing self-harm included low staffing levels, prison environments and culture, poor staff confidence and insufficient training. The importance of multidisciplinary teamwork and building staff-prisoner relationships were highlighted. Staff occasionally experienced intense psychological reactions to self-harm, which resulted in adaptive or maladaptive coping that influenced their capacity to care. CONCLUSIONS There are mixed attitudes and perceptions toward self-harm among prison staff. Further training, support and resources are required to protect staff's well-being and improve self-harm prevention and management in prisons.
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Affiliation(s)
- Thomas Hewson
- Faculty of Biology, Medicine and Health, University of Manchester, UK; and North West School of Psychiatry, Health Education England, University of Manchester, UK
| | - Kerry Gutridge
- Centre for Women's Mental Health, University of Manchester, UK
| | - Zara Bernard
- Greater Manchester Mental Health NHS Foundation Trust, UK
| | - Kathryn Kay
- Greater Manchester Mental Health NHS Foundation Trust, UK
| | - Louise Robinson
- Division of Psychology and Mental Health, University of Manchester, UK; and Lancashire and South Cumbria NHS Foundation Trust, UK
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Morris NP, Edwards ML. Addressing Shortages of Mental Health Professionals in U.S. Jails and Prisons. JOURNAL OF CORRECTIONAL HEALTH CARE 2022; 28:209-214. [PMID: 35653752 DOI: 10.1089/jchc.21.08.0072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Many jails and prisons in the United States do not have enough mental health professionals (MHPs) to meet the mental health needs of the people incarcerated in these facilities. This article examines strategies used to address MHP shortages in U.S. jails and prisons, including compensation incentives, telemental health services, interdisciplinary health care, flexible work schedules, and training rotations in correctional settings. These measures may help alleviate some of the shortages of MHPs in correctional facilities; however, these shortages will likely persist without broader policy reforms that decrease the size of U.S. correctional populations or increase the number of MHPs across the country.
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Affiliation(s)
- Nathaniel P Morris
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, California, USA
| | - Matthew L Edwards
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia, USA
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Gianvecchio VAP, Jorge MHPDM. [Suicide in the state of São Paulo, Brazil: comparing Public Safety and Health data]. CIENCIA & SAUDE COLETIVA 2022; 27:2427-2436. [PMID: 35649029 DOI: 10.1590/1413-81232022276.16112021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 09/24/2021] [Indexed: 11/22/2022] Open
Abstract
Suicide is prevalent among people of almost all ages and has a high social and economic cost. It is widely known, however, that its true prevalence is underestimated. This article aims to study suicide in São Paulo based on Public Safety data, compared with mortality information system data (SIM/MS), in order to assess possible information gains. A database (Banco SSP) was assembled from spreadsheets for police reports, complemented with existing Forensic Medicine Institute information, which was compared with the SIM/MS data. The Banco SSP database (2,469) was 7.5% higher than SIM/MS (2,297), with results reflected in the sex and age of the victims, showing the highest rates among elderly men (rate of 12.8 per 100,000 inhabitants). In relation to the method of suicide, there was a predominance of hanging (60.2%); 92.5% of unspecified cases were clarified, with an increase in deaths from exogenous poisoning (55.7%). The police reports revealed variables considered as possible risk factors for suicide, such as the mention of mental disorders (39.4%), other pathologies (5.0%), other problems (23.2%) and earlier attempted suicides (10.0%). The source studied enabled obtaining quantitative and qualitatively enhanced data compared to the SIM/MS data.
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Ricarte JJ, Caravaca-Sánchez F, Barry TJ, Aizpurua E. Suicide behaviours in incarcerated males: Links to psychopathic traits, forms of aggression to others, personal characteristics, and current penitentiary variables. J Forensic Leg Med 2022; 89:102357. [DOI: 10.1016/j.jflm.2022.102357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 04/23/2022] [Accepted: 04/27/2022] [Indexed: 11/26/2022]
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Marchi M, Artoni C, Longo F, Magarini FM, Aprile G, Reggianini C, Florio D, De Fazio GL, Galeazzi GM, Ferrari S. The impact of trauma, substance abuse, and psychiatric illness on suicidal and self-harm behaviours in a cohort of migrant detainees: An observational, prospective study. Int J Soc Psychiatry 2022; 68:514-524. [PMID: 33269641 DOI: 10.1177/0020764020979007] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND According to the WHO, detainees attempt suicide ten times more than the general population. AIMS To investigate the impact of migration trauma on Suicidal and Self-Harm Behaviours (SSHB) of migrants in jail and to explore how substance use and other psychiatric features affect this relationship. METHODS Prospective cohort study, conducted at the 'Sant'Anna' jail in Modena (Italy) between February 2017 and September 2019. Socio-demographic, psychiatric features and records of previous SSHB were collected. Experience of migration-related trauma was assessed with the LiMEs (List of Migration Experiences) checklist. Participants were followed-up for the occurrence of further SSHB. Survival analysis was performed and Cox's Hazard Ratios (HR) were used as a measure of association of comparisons. RESULTS Amongst the 112 subjects (96% male, median age 33), the prevalence of any mental disorder was 26% and of substance abuse 59%. History of SSHB was present in 36% of the sample. Median follow-up time was 80 days. During follow-up, 11 events were observed (of which three were suicide attempts). Cumulative survival probability was 85%. Having experienced trauma related to war and violence was significantly associated with SSHB, HR: 7.05. No SSHB were recorded amongst subjects without substance abuse. CONCLUSIONS Migrants in custody who experienced trauma in the post-migration period, attempt SSHB seven times more frequently than those without traumas at any time. War trauma and post-migration trauma due to exposure to violence seem to be more strongly associated with SSHB, also controlling for psychiatric diagnosis, ongoing psychopharmacological therapy and substance abuse. Further research and possible intervention programs should focus on addressing post-migration living-difficulties.
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Affiliation(s)
- Mattia Marchi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena & Reggio Emilia, Modena, Italy
| | - Cecilia Artoni
- Department of Mental Health, AUSL Modena, Modena, Emilia-Romagna, Italy
| | - Fedora Longo
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena & Reggio Emilia, Modena, Italy
| | - Federica Maria Magarini
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena & Reggio Emilia, Modena, Italy
| | - Giovanni Aprile
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena & Reggio Emilia, Modena, Italy
| | | | - Debora Florio
- Department of Primary Care, AUSL Modena, Modena, Italy
| | | | - Gian Maria Galeazzi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena & Reggio Emilia, Modena, Italy
| | - Silvia Ferrari
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena & Reggio Emilia, Modena, Italy
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Olker F, Lasczkowski G, Dettmeyer R. Rechtsmedizinische Analyse von Todesfällen Inhaftierter im Einzugsgebiet des Instituts für Rechtsmedizin Gießen. Rechtsmedizin (Berl) 2022. [DOI: 10.1007/s00194-022-00567-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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A National Study of Suicidal Ideation and Suicide Attempt Among Incarcerated People in Iran. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-022-00773-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Carter A, Butler A, Willoughby M, Janca E, Kinner SA, Southalan L, Fazel S, Borschmann R. Interventions to reduce suicidal thoughts and behaviours among people in contact with the criminal justice system: A global systematic review. EClinicalMedicine 2022; 44:101266. [PMID: 35072018 PMCID: PMC8763634 DOI: 10.1016/j.eclinm.2021.101266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 12/15/2021] [Accepted: 12/20/2021] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND People who experience incarceration die by suicide at a higher rate than those who have no prior criminal justice system contact, but little is known about the effectiveness of interventions in other criminal justice settings. We aimed to synthesise evidence regarding the effectiveness of interventions to reduce suicide and suicide-related behaviours among people in contact with the criminal justice system. METHODS We searched Embase, PsycINFO, MEDLINE, and grey literature databases for articles published between 1 January 2000 and 1 June 2021. The protocol was registered with PROSPERO (CRD42020185989). FINDINGS Thirty-eight studies (36 primary research articles, two grey literature reports) met our inclusion criteria, 23 of which were conducted in adult custodial settings in high-income, Western countries. Four studies were randomised controlled trials. Two-thirds of studies (n=26, 68%) were assessed as medium quality, 11 (29%) were assessed as high quality, and one (3%) was assessed as low quality. Most had considerable methodological limitations and very few interventions had been rigorously evaluated; as such, drawing robust conclusions about the efficacy of interventions was difficult. INTERPRETATION More high-quality evidence from criminal justice settings other than adult prisons, particularly from low- and middle-income countries, should be considered a priority for future research. FUNDING This work was funded by the Australian government's National Suicide Prevention Taskforce. RB is supported by a National Health and Medical Research Council (NHMRC) Emerging Leader Investigator Grant (EL2; GNT2008073). MW is supported by a NHMRC Postgraduate Scholarship (GNT1151103). SF was funded by the NIHR HTA Programme (HTA Project:16/159/09).
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Affiliation(s)
- Annie Carter
- Justice Health Unit, Centre for Health Equity; Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Amanda Butler
- Faculty of Health Sciences, Simon Fraser University, Vancouver, BC, Canada
| | - Melissa Willoughby
- Justice Health Unit, Centre for Health Equity; Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
- Centre for Adolescent Health; Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Emilia Janca
- Justice Health Unit, Centre for Health Equity; Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Stuart A. Kinner
- Justice Health Unit, Centre for Health Equity; Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
- Faculty of Health Sciences, Simon Fraser University, Vancouver, BC, Canada
- Mater Research Institute-UQ, University of Queensland, Brisbane, Queensland, Australia
- Griffith Criminology Institute, Griffith University, Brisbane, Queensland, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Louise Southalan
- Justice Health Unit, Centre for Health Equity; Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Seena Fazel
- Department of Psychiatry, University of Oxford; Oxford Health NHS Foundation Trust, Oxford, UK
| | - Rohan Borschmann
- Justice Health Unit, Centre for Health Equity; Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
- Centre for Adolescent Health; Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Psychiatry, University of Oxford; Oxford Health NHS Foundation Trust, Oxford, UK
- Melbourne School of Psychological Sciences; The University of Melbourne, Parkville, Victoria, Australia
- Corresponding Author: A/Prof. Rohan Borschmann, PhD DClinPsych BBSc PG-Dip (Psych) MAPS, Dame Kate Campbell Senior Research Fellow / Psychologist, Justice Health Unit, Centre for Health Equity; Melbourne School of Population and Global Health, The University of Melbourne, Level 4, 207 Bouverie street, Carlton, 3010, VIC Australia. Tel: +61 3 8344 0093; Fax: +61 3 8341 6212.
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Vanhaesebrouck A, Tostivint A, Lefèvre T, Melchior M, Khireddine-Medouni I, Chee CC. Characteristics of persons who died by suicide in prison in France: 2017-2018. BMC Psychiatry 2022; 22:11. [PMID: 34983453 PMCID: PMC8729083 DOI: 10.1186/s12888-021-03653-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 12/06/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In northern countries, suicide rates among prisoners are at least three times higher for men and nine times higher for women than in the general population. The objective of this study is to describe the sociodemographic, penal, health characteristics and circumstances of suicide of French prisoners who died by suicide. METHODS This study is an intermediate analysis of the French epidemiological surveillance program of suicides in prison. All suicides in prison in 2017-2018 in France were included in the study. Archival sociodemographic and penal data and specific data on the circumstances of the suicidal act were provided by the National Prison Service. Health data was provided by physicians working in prison using a standardized questionnaire. RESULTS In 2017-2018, 235 prisoners died by suicide. The suicide rate was 16.8/10 000 person-years. Among suicide cases, 94.9% were male, 27.2% were under 30, 25.1% were aged 30 to 39, 27.7% were aged 40 to 49 and 20.0% were 50 or older. At the time of suicide, 48.5% were on custodial remand. Incarceration is associated with a threefold increase in the frequency of anxio-depressive disorders (24.6% in prison versus 8.2% before prison). The week before the suicidal act, 60% of prisoners visited the health unit and a significant event was detected for 61% of all cases. Suicide was less than 1 week after prison entry for 11.9% of prisoners, corresponding to a suicide rate 6.4 (CI95% [4.3 - 9.5]) times higher than for the remaining time in prison, and was more than 1 year after entry for 33.7% of them. CONCLUSIONS The high frequency of events the week before suicide in our study suggests that events in prison could play a role in the occurrence of suicides. Comparative studies are needed to further explore the time association between events and suicide in prison. As most of prisoners who died by suicide visited the health unit the week before suicide, the identification of triggering factors could help psychiatrists and other health professionals to assess the short-term risk of suicide and to implement preventive measures.
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Affiliation(s)
- Alexis Vanhaesebrouck
- Interdisciplinary Research Institute On Social Issues (IRIS), UFR SMBH, Université Sorbonne Paris Nord, UMR 8156-997, Paris, France. .,Department of Legal and Social Medicine, Hôpital Jean-Verdier (AP-HP), 93140, Bondy, France. .,Pierre Louis Institute of Epidemiology and Public Health, Department of Social Epidemiology, Sorbonne Université, INSERM, Paris, France.
| | - Amélie Tostivint
- grid.494228.10000 0004 0639 9788Health division of the National Prison Service, Ministry of Justice, Paris, France
| | - Thomas Lefèvre
- grid.462844.80000 0001 2308 1657Interdisciplinary Research Institute On Social Issues (IRIS), UFR SMBH, Université Sorbonne Paris Nord, UMR 8156-997 Paris, France ,grid.414153.60000 0000 8897 490XDepartment of Legal and Social Medicine, Hôpital Jean-Verdier (AP-HP), 93140 Bondy, France
| | - Maria Melchior
- grid.418241.a0000 0000 9373 1902Pierre Louis Institute of Epidemiology and Public Health, Department of Social Epidemiology, Sorbonne Université, INSERM, Paris, France
| | | | - Christine Chan Chee
- grid.457361.2National Agency of Public Health (Santé Publique France), Saint-Maurice, France
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Ross T, Bulla J, Fontao MI. Space and Well-Being in High Security Environments. Front Psychiatry 2022; 13:894520. [PMID: 35711591 PMCID: PMC9195501 DOI: 10.3389/fpsyt.2022.894520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 05/10/2022] [Indexed: 11/13/2022] Open
Abstract
Research into the spatial dimensions of deprivation of liberty and psychiatric hospitalization has a long and complex tradition. In this context, the increasing numbers of prisoners and patients in forensic hospitals have impressively shown how difficult it is to ensure security, therapy and rehabilitation when space is scarce or not well-suited. In this narrative review, we present the main findings of recent lines of research on spaces in prisons and forensic psychiatric wards, with particular attention to the links between overcrowding in prisons and secure forensic psychiatric hospitals and violence, the foundations of prison and hospital architecture, and on how the design of spaces in prisons and hospitals can influence well-being. We assess and discuss these findings in the context of the current debate on how well-being in secure spaces can support the achievement of rehabilitation goals even in overcrowded institutions.
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Affiliation(s)
- Thomas Ross
- Forensic Psychiatry and Psychotherapy, Reichenau Psychiatric Center, Reichenau, Germany
| | - Jan Bulla
- Forensic Psychiatry and Psychotherapy, Reichenau Psychiatric Center, Reichenau, Germany
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Tully J. Management of ADHD in Prisoners-Evidence Gaps and Reasons for Caution. Front Psychiatry 2022; 13:771525. [PMID: 35370827 PMCID: PMC8973692 DOI: 10.3389/fpsyt.2022.771525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 02/04/2022] [Indexed: 12/03/2022] Open
Affiliation(s)
- John Tully
- School of Medicine, University of Nottingham, Nottingham, United Kingdom
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[Suicides in the German prison system: frequency, risk factors, and prevention]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2021; 65:18-24. [PMID: 34964913 PMCID: PMC8732920 DOI: 10.1007/s00103-021-03460-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 11/08/2021] [Indexed: 11/19/2022]
Abstract
Gefangene haben ein hohes Suizidrisiko und die höchsten Suizidraten sind bei Untersuchungsgefangenen zu verzeichnen. Suizid ist die häufigste singuläre Todesursache in deutschen Gefängnissen. In diesem narrativen Übersichtsbeitrag werden zunächst die Gefängnispopulation und ihre allgemeine Gesundheitsversorgung beschrieben, wobei insbesondere auf psychiatrische und Substanzkonsumstörungen eingegangen wird. Der Hauptteil widmet sich der Prävalenz, den Ursachen und Risikofaktoren von Gefängnissuizid. Maßnahmen zur Suizidprävention werden dargestellt. Der Anteil von Männern unter Gefangenen in Deutschland ist mit 94 % (2020) wie in allen Teilen der Welt sehr hoch. Die meisten Gefangenen sind jungen oder mittleren Alters. Die durchschnittlichen jährlichen Suizidraten bei Männern und Frauen in deutschen Gefängnissen entsprechen mit 105,8/100.000 bzw. 54,7/100.000 denen der meisten Länder in der Europäischen Union (Vollerhebung 2000–2011). Die Suizidraten bei männlichen deutschen Gefangenen sind in den Jahren 2000–2013 unabhängig vom Alter kontinuierlich zurückgegangen. Bei weiblichen Gefangenen stiegen sie dagegen an, wobei die Ursachen hierfür nicht bekannt sind. Es gibt Hinweise darauf, dass psychiatrische Erkrankungen nicht erkannt worden waren. Wichtige suizidpräventive Maßnahmen sind die Unterbringung in Gemeinschaft und die Vermeidung von Isolation, beispielsweise durch das Angebot von Arbeit. Zudem stehen validierte deutschsprachige Screeninginstrumente zur Verfügung, um ein Suizidrisiko frühzeitig zu erkennen. Für eine wirksame Gefängnissuizidprävention bedarf es der Identifikation von Hochrisikopersonen, des Angebots geeigneter suizidpräventiver Maßnahmen sowie der Entwicklung teambezogener Maßnahmen beim Gefängnispersonal.
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Willoughby M, Spittal MJ, Borschmann R, Tibble H, Kinner SA. Violence-Related Deaths Among People Released From Prison: A Data Linkage Study. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:NP13229-NP13253. [PMID: 32054375 DOI: 10.1177/0886260520905546] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
People released from prison are a socially marginalized group and are at high risk of death from preventable causes, including violence. Despite this, little is known about the epidemiology of violence-related death (VRD) after release from prison. This knowledge is essential for developing targeted, evidence-informed violence prevention strategies. We examined VRDs among a representative sample of people released from prisons in Queensland, Australia, by sex and Indigenous status. Correctional records for all people (aged ≥17 years) released from prisons from January 1994 until December 2007 (N = 41,970) were linked probabilistically with the National Death Index. The primary outcome was VRD following release from prison. We calculated crude mortality rates (CMRs) and standardized mortality ratios (SMRs) standardized by age and sex to the Australian population. We used Cox regression to identify predictors of VRD. Of 2,158 deaths after release from prison, 3% (n = 68) were violence-related. The SMR for VRD was 10.0 (95% confidence interval (CI): [7.9, 12.7]) and was greatest for women (SMR = 16.3, 95% CI: [8.2, 32.7]). The rate of VRD was 2.5 deaths per 10,000 person-years (95% CI: [2.0, 3.2]) and was highest between 2 and 6 months after release from prison (CMR = 6.3, 95% CI: [3.4, 11.6]). Risk factors for VRD included short sentences (<90 days; for males and non-Indigenous people) and experiencing two or more imprisonments (for non-Indigenous people). No significant risk factors for VRD were identified for women or Indigenous people. People released from prison die from violence at a rate that is greatly elevated compared with the general population, with women experiencing the greatest elevation in risk. Reducing the number of VRDs in this population could improve the health and wellbeing of some of our most marginalized community members.
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Affiliation(s)
- Melissa Willoughby
- The University of Melbourne, Parkville, Victoria, Australia
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | | | - Rohan Borschmann
- The University of Melbourne, Parkville, Victoria, Australia
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- King's College London, UK
| | - Holly Tibble
- The University of Melbourne, Parkville, Victoria, Australia
- The University of Edinburgh, Scotland
| | - Stuart A Kinner
- The University of Melbourne, Parkville, Victoria, Australia
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- The University of Queensland, Brisbane, Australia
- Griffith University, Brisbane, Queensland, Australia
- The University of British Columbia, Vancouver, Canada
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