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Self-harm following release from prison: A prospective data linkage study.

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One in 15 ex-prisoners presented to the emergency department for self-harm within 2.6 years of release. Risk factors include being Indigenous, mental health history, and prior self-harm presentations, highlighting needs for post-release support.

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Area of Science:

  • Public Health
  • Criminology
  • Mental Health Research

Background:

  • Prisoners face elevated risks of self-harm and suicide compared to the general population.
  • The risk of suicide post-release is notably higher (threefold) than during incarceration.
  • Incidence of self-harm following prison release remains under-researched.

Purpose of the Study:

  • To determine the incidence of self-harm presentations in adults after prison release.
  • To identify risk factors associated with self-harm presentations post-release.
  • To characterize emergency department presentations resulting from self-harm in this population.

Main Methods:

  • A cohort study involving 1325 adults interviewed pre-release.
  • Prospective linkage with correctional and emergency department records.
  • Negative binomial regression used to identify predictors of self-harm presentations.

Main Results:

  • During a median follow-up of 2.6 years, 6.4% of participants presented to the ED for self-harm.
  • Crude incidence rates were 49.2/1000 person-years for males and 60.5/1000 person-years for females.
  • Indigenous status, history of mental disorder, prior psychiatric hospitalization, and previous self-harm presentations were significant risk factors.

Conclusions:

  • Self-harm presentations to emergency departments are common among ex-prisoners post-release.
  • Identifying at-risk individuals using demographic and mental health data is crucial for suicide prevention.
  • Enhanced mental health support during and after release is vital to mitigate adverse outcomes, including self-harm.