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Baseline and Lifetime Suicidality and Risk Factors Among Pretrial Jail Detainees Enrolled in a Suicide Prevention
Sarah A Arias1, Lauren M Weinstock1, Manvinder Toor1
1Psychosocial Research Program, Butler Hospital (Arias), and Department of Psychiatry and Human Behavior, Brown University (Arias, Weinstock), Providence, Rhode Island; Charles Stewart Mott Department of Public Health, College of Human Medicine, Michigan State University, Flint (Toor, Cinader, Schall, Johnson); Department of Psychiatry, College of Osteopathic Medicine, Michigan State University, East Lansing (Cinader); Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Brown); Vagelos College of Physicians and Surgeons, Columbia University, and New York State Psychiatric Institute, New York City (Stanley). Dr. Stanley died on January 25, 2023.
Objective:
Jail detention may be a marker of suicide risk in the community. This article aimed to describe the phenomenology of suicide risk, including lifetime suicidal behaviors and comorbid conditions, observed among individuals recruited into a suicide prevention trial who passed through pretrial jail detention before returning to the community.
Methods:
Data on baseline characteristics of 800 adult participants from the SPIRIT (Suicide Prevention Intervention for At-Risk Individuals in Transition) study were analyzed.
Results:
Half the participants reported a suicide attempt in the 30 days prior to study enrollment, 85% reported at least one lifetime suicide attempt, and (93%, N=743) reported any suicidal behavior in their lifetime. Most (85%) suicide attempts in the past 30 days were made in the community, prior to arrest. Participants had a mean±SD of 14.1±53.6 lifetime suicide attempts. One-third (34%) reported that their first attempt occurred when they were ≤10 years old. Comorbid conditions were common, with high rates of problematic substance use as well as symptoms of depression, posttraumatic stress, psychosis, and mania.
Conclusions:
Individuals passing through pretrial jail detention have a complex suicide risk profile that often includes addiction, serious mental illness, and long histories of suicidal behaviors. Because most of these individuals return to the community within days, effective postdetention suicide prevention services in the community are needed.
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