A National Study of Persons Who Died by Suicide in French Prisons over the Period 2017-2021

Suicide is a leading cause of death in prisons worldwide. The objective of this study was to describe the sociodemographic, clinical and criminal characteristics of people incarcerated in France who died by suicide, as well as the circumstances surrounding each suicide. .

We included all cases of suicide by people incarcerated in France (i.e., European and overseas territories) over the period 2017-2021. The National Prison Service provided sociodemographic and criminal data, as well as data on the circumstances surrounding the suicides. Health data were collected by health units located in all the country's prisons using a standardized questionnaire.

We included 598 suicide cases in the study. Mental disorders were more prevalent during (63.7%) than before (47.8%, p < 0.001) incarceration. In the week before suicide, 60% of cases had visited their prison's health unit and a traumatic criminal-, prison-, familial- or health-related event was identified in 61% of all cases. Persons who died during the SARS-CoV2 pandemic were more likely to have children (77.7% vs 61.1%, p = 0.001). The overall suicide rate was 17.5 [CI_95% 16.1-18.9] per 10,000 person-years. It increased (p < 0.05) with age, was twice as high during pretrial incarceration and six times higher during the first week of imprisonment. In terms of gender, it was 9.9 [9.1-10.7] and 41.0 [27.0-59.7] times higher among men and women, respectively, than among their counterparts in the general population.

Suicide in prisons is a major health issue. Suicide prevention measures must be reinforced.