Suicide after release from prison: a population-based cohort study from Sweden

Area of Science:

• Criminology
• Public Health
• Psychiatry

Background:

• Released prisoners exhibit significantly higher suicide rates than the general population.
• Understanding specific risk factors and causal pathways for suicide post-release is crucial for intervention.
• Previous research on suicide risk in this demographic is limited.

Purpose of the Study:

• To investigate the incidence rates and risk factors associated with suicide among individuals released from prison.
• To compare suicide rates and psychiatric morbidity in released prisoners versus non-convicted controls.
• To identify independent predictors of suicide in the post-release period.

Main Methods:

• Population-based cohort study utilizing Swedish national registers (2005-2009).
• Follow-up of 26,985 individuals released from prison until death, emigration, or re-incarceration.
• Survival analyses comparing incidence rates and psychiatric morbidity with matched general population controls.

Main Results:

• 127 suicides occurred among 38,995 releases, representing 14% of all post-release deaths.
• The suicide rate was 204 per 100,000 person-years, an 18.2-fold increased incidence rate compared to controls.
• Independent risk factors included prior substance use disorder (HR=2.1), history of suicide attempt (HR=2.5), and being born in Sweden (HR=2.1).

Conclusions:

• Released prisoners are at a substantially elevated risk for suicide.
• Psychiatric risk factor patterns for suicide differ slightly between released prisoners and the general population.
• Targeted resources for reintegration and focused attention on individuals with a history of suicide attempts and substance use disorders are recommended.