Suicide in recently released prisoners

Hypotheses: Suicide was expected to be more likely amongst released prisoners than the general population. Risk factors would include being on remand, charged or convicted with a violent offence, being released from a local prison, having had mental health problems, misused alcohol/substances, a history of suicidal behaviour, and a poor level of post-release engagement with community services. Method: This case-control study identified all suicides and probable suicides between 2000 and 2002, committed by offenders within 12 months of their release from prison in England and Wales. One matched control was recruited for each case. Suicide rates per 100,000 person-years were compared with rates in the general population using the indirectly age-standardised mortality ratio. Information on case and controls was obtained from various official databases and locally held personal records. Logistic regression modelling was used to identify key factors related with an increased risk of post-release suicide. Findings: Out of 256,920 recently released prisoners, 384 offenders committed suicide within a year of release from prison, producing a suicide rate of 150 per 100,000 person-years. Seventy nine (21%) suicides occurred within the first 28 days after release. Released males were 8 times and females 36 times more likely to commit suicide than expected in the general population. Individuals with a history of alcohol misuse, a history of self harm and a psychiatric diagnosis were identified as at greatest risk of post-release suicide. Local prisons were associated with a 2-fold increase in offenders' risk of post-release suicide and suicides were more likely amongst those in contact with mental health services. Interpretation: Recently released prisoners are at a much greater risk of suicide than the general population, especially in the first few weeks after release. The risk of suicides in recently released prisoners is approaching that observed in discharged psychiatric patients. A shared responsibility lies with the prison, probation, health and social services to develop more collaborative practices in providing services for this at-risk group.EThOS - Electronic Theses Online ServiceGBUnited Kingdo