Attempted Suicide: A Multilevel Examination of Inmate Characteristics and Prison Context

Abstract

Correctional institutions in the United States witness higher rates of suicide compared with the general population, as well as a higher number of attempted suicides compared with completed cases. Prison research focused little attention on investigating the combined effects of inmate characteristics and prison context on suicide, with studies using only one level of analysis (prison or prisoner) and neglecting the nested nature of inmates in prisons. To extend this literature, multilevel modeling techniques were employed to investigate individual- and prison-contextual predictive patterns of attempted suicide using a nationally representative sample of 18,185 inmates in 326 prisons across the United States. Results revealed that several individual-level factors predicted odds for attempted suicide, such as inmate characteristics/demographics, prison experiences, having a serious mental illness, and symptoms of mental health issues. Some prison-contextual variables, as well as cross-level interaction effects, also significantly predicted odds for attempted suicide. Policy and research implications are discussed.

The relationship between age and suicidal thoughts and attempted suicide among prisoners

“…Drawing from the above findings, prison administrators should consider allocating resources to the identification, assessment, and treatment of prisoners at risk of suicidal ideation and behavior across the lifespan, but especially around young adulthood and mid-life. For younger prisoners, it would be appropriate to target behavioral risk and the associated precipitating factors; in this effort, prison administrators and mental health professionals should acknowledge both individual-and prison-level contributory factors (see Stoliker, 2018;Stoliker et al, 2020). Furthermore, given the high lethality of attempts among older individuals, along with the challenges imposed by older individuals' reluctance to express suicidal thoughts, it is especially important to implement routine screening of older prisoners to identify the nature and extent of suicidal risk.…”

“…Despite a growing body of literature focused on suicide among older and aging adults, along with the trend toward an aging prison population, there is a marked lack of empirical research on the nature of suicidal thoughts and behavior among older prisoners (e.g., see Barry et al, 2017;Opitz-Welke et al, 2019). Studies have, in some capacity, considered the relationship between age and suicidal thoughts/behavior among prisoners (e.g., see Blaauw, Winkel, & Kerkhof, 2001;Dye, 2010;Favril, Stoliker, & Vander Laenen, 2020;Marzano, Hawton, Rivlin, & Fazel, 2011;Stoliker, 2018), but this research has produced mixed findings. Some evidence suggests that prisoners who engage in suicidal behavior tend to be younger (Blaauw et al, 2001;Daniel & Fleming, 2006;Liebling, 1999;Marzano et al, 2011) and that an increase in age corresponds to decreased odds of reporting a previous suicide attempt compared to no attempt (Stoliker, 2018) and suicidal ideation only (Favril et al, 2020).…”

“…Research that captures incidence of suicidal thoughts and behavior in the prison setting would be in better position to estimate the effects of criminological and institutional factors. In this case, the nature of an offender's legal situation and sentence, as well as experiences of prison life (Stoliker, 2018;Stoliker et al, 2020), may be important predictors of suicidal ideation and behavior. Third, the self-report nature of the survey also presents some limitation as prisoners may be unwilling to provide accurate responses on sensitive items (Favril et al, 2020), despite being informed that responses would be kept confidential.…”

What differentiates prisoners who attempt suicide from those who experience suicidal ideation? A nationally representative study

“…Data for this study came from the 2004 Survey of Inmates in State and Federal Correctional Facilities (SISFCF), a cross-sectional epidemiological survey designed to monitor characteristics and health of prisoners in the United States (US). This is the latest survey in a series of data collection efforts designed by the US Bureau of Justice Statistics, previously used in research on suicidal behavior in prisoners (Katsman & Jeglic, 2019;Stoliker, 2018). This survey collected data between October 2003…”

“…Extant research seeking to identify suicide risk factors in prisoners tends to compare those who attempted suicide with their non-attempting peers, irrespective of suicidal ideation (e.g., Favril, 2019;Jenkins et al, 2005;Sánchez, Fearn, & Vaughn, 2018;Sarchiapone et al, 2009;Stoliker, 2018).…”