Inmate-to-inmate violence as a marker of suicide attempt risk during imprisonment

To estimate the incidence of suicide attempts during imprisonment in a French prison and to determine factors associated with them.

All male inmates of a prison for prisoners awaiting trial or serving a short sentence (Bordeaux, France) were eligible for this cross-sectional study. They were face-to-face interviewed by an experienced psychologist (n = 369; mean age = 36 years). Socio-demographic data, imprisonment conditions, health status, healthcare utilization, mental health, impulsiveness, inmate-to-inmate violence (victim and perpetrator status) and suicidal behaviours were documented.

The incidence of suicidal attempts during imprisonment was 13.4 per 100 person-years. Having made at least one suicide attempt during imprisonment was associated with: being a victim of physical or sexual violence without perpetrating it (adjusted OR = 5.4; 95%CI [2.4-12]), suffering from depressive and anxious symptoms (adjusted OR = 3.3; 95%CI [1.5-7.7]), having children (adjusted OR = 3.0; 95%CI [1.2-7.7]) and having a poor perceived health status (OR = 2.5; 95%CI [1.1-5.4]). A history of suicide attempt before imprisonment was not associated with the risk of suicide attempts while imprisoned.

Our results suggest that violence plays a major role in the suicidal process in prison. The inclusion of inmate-to-inmate violence in the screening checklists of inmate suicide risk should be explored.