Although suicide rates among prisoners are high and vary between countries, it is uncertain whether this reflects the importation of risk from the general population or is associated with incarceration rates.
We collected data on suicides and undetermined deaths in 12 countries (Australia, Belgium, Canada, Denmark, England and Wales, Finland, Ireland, Netherlands, New Zealand, Norway, Scotland, and Sweden) directly from their prison administrations for 2003–2007. These were compared with rates of suicides in the general population separately by gender using Pearson’s correlations. In addition, they were compared with rates of incarceration. Linear regression was used to examine any association after adjustment for rates of incarceration.
Data were collected on 861 suicides in prison, of which 810 were in men. In the men, crude relative rates of suicide were at least three times higher than the general population. Western European countries had similar rates of prisoner suicide which were mostly higher than those in Australia, Canada, and New Zealand. There was no association between rates of suicide in prisoners and general population rates or rates of incarceration. In the women, inmate suicide rates varied widely and were mostly raised compared with rates in the general population. In addition, these rates did not appear to be associated with general population rates of suicide.
Rates of prison suicide do not reflect general population suicide rates, suggesting that variations in prison suicide rates reflect differences in criminal justice systems including, possibly, the provision of psychiatric care in prison.
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We are grateful to Lars Nylén, Director General of the Swedish Prison and Probation Service, for writing to colleagues in various countries requesting data, and to the following individuals in prison administrations for supplying prison suicide data: Tunde Adeniji for England and Wales, Bill Staubi for Canada, Julie Miller for New Zealand, Ragnar Kristoffersen for Norway, Yvonne Walsh for Ireland, Peter Løvgreen for Denmark, Willy Van den Bergh for Belgium, and Ed Wozniak for Scotland. We also appreciate the assistance of Jan Hoogenboezem, Kees van Heeringen, Sunny Collins, Steve Platt, Lars Mehlum, Grethe Westby, Udo Reulbach, Merete Nordentoft, and Ella Arensman in gathering data on national suicide rates. Sophie Anwar helped collect Australian data. There was no specific funding for this project.
Conflict of interest statement
The authors report no conflict of interests.
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Fazel, S., Grann, M., Kling, B. et al. Prison suicide in 12 countries: an ecological study of 861 suicides during 2003–2007. Soc Psychiatry Psychiatr Epidemiol 46, 191–195 (2011). https://doi.org/10.1007/s00127-010-0184-4