[Suicidal behaviour among prisoners: prevalence and association with psychological distress in Flemish prisons]

Internationally, the prevalence of suicidal behaviour (suicidal ideation, suicide plan and attempted suicide) is significantly elevated among prisoners compared to the community at large.

To estimate the prevalence of suicidal behaviour among prisoners in the Flanders region of Belgium, to identify differences according to gender and custodial status, and to examine the association of recent suicidal ideation and suicide plan with psychological distress.

We performed a cross-sectional survey using a representative sample of 1,326 prisoners, randomly selected from 15 Flemish prisons.

During their lifetime, an estimated 44.4% of prisoners in Flanders reported suicidal ideation, 30.2% made a suicide plan, and one-fifth (21.8%) attempted suicide at least once. Past-year suicidal ideation in prison was endorsed by one-fourth (24.9%) of all prisoners, and 14.3% made a recent suicidal plan during their current incarceration. Approximately one in ten prisoners (9.5%) attempted suicide while in prison. Recent suicidal ideation and suicide plan were significantly associated with high levels of psychological distress. Generally, female prisoners reported significant higher levels of suicidal behaviour than men, while differences according to custodial status were less unequivocal.

Corroborating international research findings, high rates of suicidal behaviour were identified among prisoners in Flanders, compared to the general population. Not only is suicidal behaviour a significant risk factor for suicide, it is also important in its own right as an indicator of profound psychological distress. Suicidal behaviour should therefore be an important target for prevention and intervention in this at-risk population.