Suicide by prisoners. National clinical survey

The number of suicides in prison has increased over recent years. This is the first study to describe the clinical care of a national sample of prison suicides.

To describe the clinical and social circumstances of self-inflicted deaths among prisoners.

A national clinical survey based on a 2-year sample of self-inflicted deaths in prisoners. Detailed clinical and social information was collected from prison governors and prison health care staff.

There were 172 self-inflicted deaths: 85 (49%; 95% CI 42-57) were of prisoners on remand; 55 (32%; 95% CI 25-39) occurred within 7 days of reception into prison. The commonest method was hanging or self-strangulation (92%; 95% CI 88-96). A total of 110 (72%; 95% CI 65-79) had a history of mental disorder. The commonest primary diagnosis was drug dependence (39, 27%; 95% CI 20-35). Eighty-nine (57%; 95% CI 49-64) had symptoms suggestive of mental disorder at reception into prison.

Suicide prevention measures should be concentrated in the period immediately following reception into prison. Because hanging is the commonest method of suicide, removal of potential ligature points from cells should be a priority.