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1324 prison suicides in 10 countries in South America: incidence, relative risks, and ecological factors

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Abstract

Purpose

Although suicide rates of prison populations and incidence factors have been reported for high-income countries, data from low- and middle-income regions are lacking. The purpose of the study was to estimate suicide rates among prison populations in South America, to examine prison-related factors, and to compare suicide rates between prison and general populations.

Methods

In this observational study, we collected the numbers of suicides in prison, rates of prison occupancy, and incarceration rates from primary sources in South America between 2000 and 2017. We compared suicide rates among prisoners with incidence rates in the general populations by calculating incidence rate ratios. We assessed the effect of gender, year, incarceration rates and occupancy on suicide rates in the prison populations using regression analyses.

Results

There were 1324 suicides reported during 4,437,591 person years of imprisonment between 2000 and 2017 in 10 South American countries. The mean suicide rate was 40 (95% CI 16–65) per 100,000 person years for male and female genders combined. The pooled incidence rate ratio of suicide between prison and general populations was 3.9 (95% CI 3.1–5.1) for both genders combined, 2.4 (95% CI 1.9–3.1) for men and a higher ratio in women (13.5, 95% CI 6.9–26.9). High occupancies of prisons were associated with lower incidence of suicide (β = − 58, 95% CI − 108.5 to − 7.1).

Conclusions

Suicides during imprisonment in South America are an important public health problem. Suicide prevention strategies need to target prison populations.

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Acknowledgements

The authors wish to acknowledge and thank José Pedro Rossi and Santiago Sosa Barón of the Parliamentary Commission for the Prison System of the Uruguayan Parliament (Montevideo, Uruguay), and Ramiro Gual and Liliana Martinez of the Procuración Penitenciaria de la Nación (Buenos Aires, Argentina). This work was supported by the Wellcome Trust [Grant number 202836/Z/16/Z] and the Comisión Nacional de Investigación Cientifica y Tecnologica, Ministry of Education, Republic of Chile [Grant FONDECYT Regular number 1190613].

Author information

Authors and Affiliations

  1. Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany

    Francesco Domenico Fritz

  2. Department of Psychiatry, Hospital Clínico Universidad de Chile, Santiago, Chile

    Francesco Domenico Fritz

  3. Department of Psychiatry, University of Oxford, Oxford, UK

    Seena Fazel

  4. Ministry of Public Health, Quito, Ecuador

    Andrés Benavides Salcedo

  5. Department of Sociology, University of Guyana, Georgetown, Guyana

    Paulette Henry

  6. Department of Psychology, Private University of Santa Cruz de la Sierra, Santa Cruz de la Sierra, Bolivia

    Guillermo Rivera Arroyo

  7. Department of Psychiatry, School of Medical Sciences, National University of Asunción, San Lorenzo, Paraguay

    Julio Torales

  8. Mental Health Research Group, National Faculty of Public Health, University of Antioquia, Medellin, Colombia

    Natalia Trujillo Orrego

  9. Suicide Prevention Program, National Institute for Mental Health, Lima, Peru

    Freddy Vásquez

  10. Medical Faculty, Universidad Diego Portales, Santiago, Chile

    Adrian P. Mundt

  11. Medical Faculty, Universidad San Sebastián, Puerto Montt, Chile

    Adrian P. Mundt

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  1. Francesco Domenico Fritz
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Contributions

The study was designed by SF and APM. FDF conducted the literature search. FDF, ABS, PH, GRA, JT, NTO, FV and APM contributed to the data collection. Analyses were conducted by FDF, SF and APM. The manuscript was drafted by FDF and APM. FDF, SF, ABS, PH, GRA, JT, NTO, FV and APM critically revised the manuscript and approved of the final version.

Corresponding author

Correspondence to Adrian P. Mundt.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

Ethical approval was obtained from the Universidad de Antioquia (Colombia). The authors assert that all procedures contributing to this work comply with the Helsinki Declaration of 1975, as revised in 2008.

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Fritz, F.D., Fazel, S., Benavides Salcedo, A. et al. 1324 prison suicides in 10 countries in South America: incidence, relative risks, and ecological factors. Soc Psychiatry Psychiatr Epidemiol 56, 315–323 (2021). https://doi.org/10.1007/s00127-020-01871-3

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