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Suicide rates among people in prison are dramatically higher than those in the general population, although this varies greatly among countries. This is the conclusion of a recent study using data from 24 countries, including Canada, from the years 2011- to 2014, and covering nearly 4000 prison suicides. 20 of the countries were in Europe plus Australia, New Zealand, Canada and the USA. On average, men in jail were about three times as likely to kill themselves as men in the general population, but for women the risk was nine times as great, a huge discrepancy. Many aspects of prison, such as being cut off from family or lack of access to high quality health care, are understood to contribute to the risk of mental health problems or suicide.
On the other hand, suicide rates in prisons did not seem to vary based on the risk factors one would normally expect. For example, Norway, where prisons are considered relatively less punitive places, had a very high suicide rate whereas the United States, where conditions can often be quite harsh, had the lowest suicide rate for prisoners. Norway also had the largest discrepancy between suicide rates in prison and in the general population; prisoners were 14 times as likely to kill themselves!
As a benchmark, the general population suicide rate in Canada given in the article is a little over 11 per 100,000 men and women aged 30-50 per year, while Canada’s prison suicide rate is reported as 27 per 100,000 per year. By comparison, Poland had a similar prison suicide rate of 24 per 100,000 but this rate is almost exactly the same as the suicide rate in the general population. On the other hand, Italy and Portugal both reported more than ten times as high a suicide rate in prisons. Croatia actually reported a lower rate of suicides in prison than in the population – the only country in the survey to do so. New Zealand had a much higher rate of prison suicides relative to population than did neighbouring Australia. Iceland, Norway and France had prison suicide rates 9 times that of Canada.
Higher suicide rate among women prisoners
As mentioned, the suicide rate among female prisoners was significantly higher than that for men overall and, therefore, in most of the countries. Unfortunately, the study does not report the gender difference for Canada. In Northern Ireland, men in prison have a lower suicide rate than the general population but women have a rate ten times as high. France, Portugal and Denmark have high rates of prison suicide for both men and women, but the rates for women are much, much higher – as much as 7 times as high in France.
Other risk factors not evident
On average, countries that locked up a higher proportion of people had lower suicide rates. The researchers speculate that this may be because those jailed in such situations have likely committed more serious crimes, which is itself a risk factor for suicide. However this is an educated guess; they don’t have evidence on this point.
The study did look at factors in the prisons, such as how crowded they were, or turnover among prisoners, or average length of imprisonment but none of these factors were related to suicide rates. The researchers argue that suicides are likely a result of multiple factors related both to the individual prisoner – for example a history of mental health problems – and to the situation – for example, availability of mental health care or lack of meaningful social connections in jail.
Suicide in prison, as suicide generally, is a complex phenomenon that is very difficult to predict with any accuracy. However given high suicide rates in prisons, the authors call on all countries to investigate carefully what steps might be taken to reduce the incidence and then to take action.
This post is drawn with permission from a blog posting by Prison Reform International and is available at https://www.penalreform.org/blog/suicide-in-prison-a-new-study-on-risk/. PRI is a non-profit organization that support prison reform in countries in eastern Europe, Africa and Asia.
The full report of the study is titled ‘Suicide in prisons: an international study of prevalence and contributory factors’. It was written by Seena Fazel, Taanvi Ramesh, and and Keith Hawton, all working in England. The article is open access and available at: http://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(17)30430-3/supplemental