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A Population-Based Study of the Prevalence and Correlates of Self-Harm in Juvenile Detention
Hygiea Casiano1, Shay-Lee Bolton2, Keith Hildahl1
1Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada.
Background:
Suicide is the number one cause of death among incarcerated youth. We examined the demographic and forensic risk factors for self-harm in youth in juvenile detention using a Canadian provincial correctional database.
Method:
We analyzed data from de-identified youth aged 12 to 18 at the time of their offense who were in custody in a Manitoba youth correctional facility between January 1, 2005 and December 30, 2010 (N = 5,102). Univariate and multivariate logistic regression analyses determined the association between staff-identified self-harm events in custody and demographic and custodial variables. Time to the event was examined based on the admission date and date of event.
Results:
Demographic variables associated with self-harm included female sex, lower educational achievement, older age, and child welfare involvement. Custodial variables associated with self-harm included higher criminal severity profiles, younger age at first incarceration, longer sentence length, disruptive institutional behavior, and a history of attempting escape. Youth identified at entry as being at risk for suicide were more likely to self-harm. Events tended to occur earlier in the custodial admission.
Interpretation:
Self-harm events tended to occur within the first 3 months of an admission stay. Youth with more serious offenses and disruptive behaviors were more likely to self-harm. Individuals with problematic custodial profiles were more likely to self-harm. Suicide screening identified youth at risk for self-harm. Strategies to identify and help youth at risk are needed.
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