Self-injury and suicide attempt in incarcerated women: prevalence and risk factors

Abstract

Purpose: To assess the prevalence and risk factors for self-injury and suicide attempt in prison in a sample composed of 186 female inmates. Methods: Sociodemographic data, measures of depression, self-destructive behavior, suicide attempt, and other specific questions related to the reality in the prison environment were collected. Results: Self-injury and suicide attempt before incarceration was reported by 11.3% and 35.5% of the sample, respectively. During imprisonment, a prevalence of 29% and 18.8% for self-injury and suicide attempt, respectively, was observed. Multiple binary logistic regression identified the following risk factors for self-injury: age <32 years, depressive symptoms, history of torture at the time of the arrest, aggression in prison, and sexually transmitted infection. Conversely, the risk factors for suicide attempt were depressive symptoms, self-injury history, aggression in prison, and sexually transmitted infection. Conclusion: This study confirmed the high prevalence of self-harm and suicide attempts in female prisoners. Specific screening tools and the institution of public policies to assess and provide mental health care for incarcerated people in Brazil are needed.

Prevalence and risk factors for suicide attempts in prison

“…Targeted searches were also conducted to identify additional studies by first author names, and experts were contacted for any unpublished or ongoing investigations. Our initial search was updated (using the same keywords and databases) to identify new studies published up to May 31, 2022, which yielded an additional four investigations that were eligible for inclusion (Caravaca-Sanchez et al, 2021;Carvalho et al, 2021;Ford et al, 2020;Howard & Wakeling, 2020).…”

“…We contacted authors of studies that collected data on suicide attempts in prison but did not provide information required for meta-analysis, including those that only reported prevalence (Dudeck et al, 2011), analysed self-injury (Carvalho et al, 2021) or a lifetime history of suicide attempt among prisoners with suicidal ideation (Favril & O'Connor, 2021;Larney et al, 2012), and adopted a cluster analytical approach (Bani et al, 2019). These five studies (n = 4969) were retained after the necessary unpublished data (associations with inprison suicide attempts in the overall sample) were obtained from the study authors.…”

“…Third, few studies examined risk factors for suicide attempts in female samples. Only three investigations specifically focused on women (Caravaca- Sanchez et al, 2021;Carvalho et al, 2021;Marzano et al, 2010Marzano et al, , 2011) and all but one & Wakeling, 2020) of the studies that included both male and female individuals did not provide data disaggregated by sex. Consequently, although originally planned, we were not able to conduct subgroup analyses by sex, and so it remains uncertain whether the risk factors-based on predominantly male samples-equally relate to incarcerated women.…”

“…Fourth, despite our global literature search, we identified only one eligible study from a low or middle income country (Carvalho et al, 2021). Therefore, caution should be exercised in generalising study findings to developing countries with resource-poor correctional systems, where some of the identified risk factors (e.g., psychiatric disorders) are common (Baranyi et al, 2019).…”

Influence of international commitments against torture on prison indicators: measuring human rights

“…Another literature review of productions on the prison system in Brazil pointed out that women reported more than men suffering from verbal and sexual aggression, falls, suicide attempts, homicide and stabbing with a knife . If this suffering of women in prison it's a serious problem (Carvalho et al, 2021) and is greater than that of men, as these recent surveys and others suggest (Moraes et al, 2020), it is worth asking whether the treatment given to them has been worse than the treatment given to men. They may be more victims of torture than men.…”