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Few researchers have empirically examined completed or attempted death by suicide in prison and, of the available research, most has been conducted in the United Kingdom. Our purpose in this article is to increase awareness and knowledge about “lives saved” in custody drawing on the voices of Canadian provincial and territorial correctional officers (COs; n = 43). We investigate their experiences with attempted and completed death by suicide to shed light on the commonality of such experiences, and their impact on officers over time. Based on an analysis of semi-structured interview transcripts, we explore the effects of exposure to these potentially psychologically traumatic events on COs, specifically their emotional responses, as well as the supports available, both informal and formal, as they navigate their work. We found that the roles of officers, which frequently overlap with the domains of mental health support and first response in a crisis situation, are often under-recognized and underappreciated. Ultimately, we highlight the need for increased dialogue surrounding workplace trauma and mental health in prison and explore the institutional barriers that arise when facilitating discussion about mental health. We show that although some lives are lost in prison, due to natural and nonnatural causes, many lives are saved by prison staff.

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The ketogenic diet (KD) is characterized by a diet ratio of 4:1 fat to non-fat energy sources. For decades KD has been successfully used to control seizures in epilepsy patients. Investigations into its mechanism of action suggest that it may have an effect on the metabolic, nervous, immune, and digestive systems. In this review, we postulate that KD may also improve depressive symptoms – for that, we highlight the similarities between depression and epilepsy, describe the extent to which body systems involved in both conditions are affected by the KD, and ultimately hypothesize how KD could improve MDD outcomes. Research into animal models and human patients have reported that KD can increase mitochondrial biogenesis and increase cellular resistance to oxidative stress both at the mitochondrial and genetic levels. Its effect on neurotransmitters alters cell-to-cell communication in the brain and may decrease hyperexcitability by increasing Gamma Aminobutyric Acid (GABA) and decreasing excitatory neurotransmitter levels. Its anti-inflammatory effects are mediated by decreasing chemo- and cytokine levels, including TNF-alpha and IL-1 levels. Finally, KD can alter gut microbiota (GM). Certain strains of microbiota predominate in major depressive disorder (MDD) when compared to healthy individuals. Recent evidence points to Bacteroidetes as a potential treatment predictor as it seems to increase in KD treatment responders for epilepsy. Each of these observations contributes to the presumed modulatory effects of KD on mood and supports its potential role as antidepressant.

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