Characteristics of Inmates Who Initiate Hunger Strikes

A hunger strike is a common, expensive, and potentially lethal event within a correctional institution. In this study, we describe the characteristics of inmates who initiated hunger strikes in a state prison system. Electronic medical records for a state prison system were reviewed for documentation of hunger strikes from January 2005 through September 2015. There were 292 hunger strikes during the study period. Most (71%) lasted three or fewer days. When weight data were available, only 12.9 percent of the hunger strikes resulted in a weight loss >10 percent. Mental health patients were disproportionately represented in the sample (45%), although diagnoses of personality disorders (48%) rather than mood (17%) or psychotic (10%) disorders accounted for most of these cases. Nearly 75 percent of inmates who initiated hunger strikes did so while residing in disciplinary housing. In more than 80 percent of the strikes, the reason for stopping the strike was unknown. When the reasons were known, custody intervention rather than mental health intervention was the most common reason for the ending of a strike. Improving communication with custody administration and mitigating unnecessarily aversive housing environments are likely to reduce the incidence of hunger strikes.