A 17-Year National Study of Prison Suicides in Belgium

Favril, Louis; Wittouck, Ciska; Audenaert, Kurt; Laenen, Freya Vander

doi:10.1027/0227-5910/a000531

Cited by 28 publications

(34 citation statements)

References 59 publications

(85 reference statements)

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“…Specifically, self-report approaches to clinical diagnosis are not without problems, and clinician-administered diagnostic interviews would be a more accurate approach [52]. Finally, since differences exist between risk factors for fatal and non-fatal suicidal behaviours [53], the current findings may not be generalisable to prisoners who die by suicide [54].…”

Section: Limitationsmentioning

confidence: 89%

Factors associated with the transition from suicidal ideation to suicide attempt in prison

et al. 2020

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Background Although research has identified a wide range of risk factors for suicidal behavior in prisoners, it does not establish who is most likely to act on their suicidal thoughts while incarcerated. Methods Self-report data were collected from a random sample of 1,203 adult men incarcerated across 15 prisons in Belgium, who represent 12% of all male prisoners nationwide. Results One-third (33%) of participants reported having suicidal thoughts during their incarceration, of whom 26% attempted suicide in prison (9% of all prisoners). Factors independently associated with suicide attempt among prisoners with suicidal ideation were violent offending (adjusted odds ratio [aOR] = 2.64, 95% confidence interval [CI] 1.33–5.23), in-prison drug use (aOR = 2.30, 95% CI 1.25–4.22), exposure to suicidal behavior (aOR = 1.96, 95% CI 1.04–3.68), and a lifetime history of nonsuicidal self-injury (aOR = 1.90, 95% CI 1.08–3.36). While related to suicidal thoughts, markers of psychiatric morbidity and aspects of the prison regime were not associated with the progression to suicide attempt. Conclusions Many prisoners who think about suicide do not attempt suicide while incarcerated. Factors associated with suicidal ideation are distinct from those that govern the transition to suicidal behavior. Our findings lend support to the hypothesis that behavioral disinhibition might act as a catalyst in the translation of suicidal thoughts into action.

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Section: Limitationsmentioning

confidence: 89%

Factors associated with the transition from suicidal ideation to suicide attempt in prison

et al. 2020

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“…Prisoners are more likely than others to be exposed to such adverse events, either prior to or during incarceration (Favril, 2019; Fazel et al, 2008; Sarchiapone et al, 2009). As a result, prisoners may experience greater suicide capability (Smith et al, 2016), potentially explaining their increased risk of suicide (Favril et al, 2019; Fazel et al, 2017). While our data, however tentative, support the conceptual link between risk of suicide and painful and provocative events, we were unable to directly test the theoretical claims proposed because we used proxies to, rather than explicit measures of, suicide capability.…”

Section: Discussionmentioning

confidence: 99%

“…Suicide is a global public health concern (Turecki et al, 2019) which disproportionally impacts on the most vulnerable members of society, including people exposed to the criminal justice system (Webb et al, 2011). Specifically, suicide is a leading cause of death in prisoners (Favril, Wittouck, Audenaert, & Vander Laenen, 2019), with rates at least three times higher than in age‐equivalent peers outside prison (Fazel, Ramesh, & Hawton, 2017). Prisoners who die by suicide only represent the tip of the iceberg; many more consider or attempt suicide without a fatal outcome.…”

Section: Larney Et Al (2012) Favril and O'connor (2019) Favril Et mentioning

confidence: 99%

What Differentiates Prisoners Who Attempt Suicide from Those Who Experience Suicidal Ideation? A Nationally Representative Study

Favril

Stoliker

Laenen

2020

Suicide & Life Threat Behav

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Many people who think about suicide do not engage in suicidal behavior. Identifying risk factors implicated in the process of behavioral enaction is crucial for suicide prevention, particularly in high-risk groups such as prisoners. Method: Cross-sectional data were drawn from a nationally representative sample of 17,891 prisoners (79% men) in the United States. We compared prisoners who attempted suicide (attempters; n = 2,496) with those who thought about suicide but never made an attempt (ideators; n = 1,716) on a range of established risk factors. Results: More than half (59%) of participants who experienced suicidal ideation had also attempted suicide. Violent offending, trauma, brain injury, alcohol abuse, and certain mental disorders distinguished attempters from ideators. Conclusion: Our results fit within recent ideation-to-action theories that emphasize the role of a capability for suicide in the transition from thoughts to acts of suicide. Suicide is a global public health concern (Turecki et al., 2019) which disproportionally impacts on the most vulnerable members of society, including people exposed to the criminal justice system (Webb et al., 2011). Specifically, suicide is a leading cause of death in prisoners (Favril, Wittouck, Audenaert, & Vander Laenen, 2019), with rates at least three times higher than in age-equivalent peers outside prison (Fazel, Ramesh, & Hawton, 2017). Prisoners who die by suicide only represent the tip of the iceberg; many more consider or attempt suicide without a fatal outcome. Large-scale studies from Australia

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“…Such obstructed access to inmates would make monitoring of psychological deterioration difficult and possibly under detected. From the observed self-harm in SC and the finding that inmates commit suicide in prison despite increased monitoring (68), it seems evident that simple monitoring in SC is not sufficient and that psychological support is required. Secondly, the design of SC generally denies inmates vocational programming, regular and unobstructed visitation, or opportunities for pro-social interactions; all of which are necessary for inmates' mental health in prison and their successful release into community (69,70).…”

Section: Discussionmentioning

confidence: 99%

Shedding Light on “the Hole”: A Systematic Review and Meta-Analysis on Adverse Psychological Effects and Mortality Following Solitary Confinement in Correctional Settings

et al. 2020

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Objectives: To systematically review and meta-analyze the psychological effects and mortality rate in inmates having been exposed to solitary confinement in correctional settings. Methods: PubMed, PsycINFO, Web of Science, and Google Scholar were searched using keywords describing solitary confinement in combination with keywords for psychological or mortality outcomes. Eligible case-control studies for the systematic review met an operational definition for solitary confinement and evaluated outcomes after exposure to such confinement. Studies presenting statistical data which allowed to compute standardized mean differences for symptom scales or odds ratio for mortality were further meta-analyzed using random-effects models. Results: Systematic review identified 13 studies for inclusion, with a total sample of 382,440 inmates (23% having been exposed to solitary confinement). Higher quality evidence showed solitary confinement was associated with an increase in adverse psychological effects, self-harm, and mortality, especially by suicide. Meta-analysis of five studies (n = 4,517) showed a standardized mean difference of 0.45 for general psychological symptomatology, which increased to 0.51 upon outlier exclusion. Small to moderate significant effects were observed for mood, psychotic, and hostility symptoms specifically. In addition, meta-analysis of two mortality studies (n = 243,050) showed a trend for a moderate effect for mortality by any or unnatural causes (i.e., suicide, homicide, overdose, and accidents). Conclusions: Analyses showed that solitary confinement is associated with the psychological deterioration of inmates. This effect appears to be beyond that of general incarceration or presence of prior mental illness. Thus, solitary confinement may pose

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A 17-Year National Study of Prison Suicides in Belgium

Abstract: Suicide is a common, preventable cause of death among prisoners in Belgium. The results underscore the timely need for national standards and guidelines for suicide prevention in Belgian prisons.

Cited by 28 publications

References 59 publications

Factors associated with the transition from suicidal ideation to suicide attempt in prison

Factors associated with the transition from suicidal ideation to suicide attempt in prison

What Differentiates Prisoners Who Attempt Suicide from Those Who Experience Suicidal Ideation? A Nationally Representative Study

Shedding Light on “the Hole”: A Systematic Review and Meta-Analysis on Adverse Psychological Effects and Mortality Following Solitary Confinement in Correctional Settings

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