The Gender Paradox in Prison Suicide Rates

Few studies of prison suicide have focused on suicide among female inmates, and even fewer studies have provided comparisons of rates by gender. Using national data on U.S. prisons and suicide, this study examined the “gender paradox” in prison suicide rates by comparing suicide rates of female and male inmates and U.S. residents and then examined characteristics of prisons that reported suicides. Findings indicated that rates of suicide in prison were similar for female and male inmates, but rates were higher for female inmates and lower for male inmates compared to the respective rates for female and male U.S. residents. Prisons that reported female suicides evidenced significant differences in prison conditions, including higher assault rates and mental health service utilization, compared to prisons for males and female prisons without suicide. Implications of the findings for understanding the gender paradox and for prison suicide prevention are discussed.     

Preventing Suicide in Jails and Prisons: Suggestions from Experience with Psychiatric Inpatients

Abstract:  Both among psychiatric inpatients and inmates of prisons and jails, suicide is highly prevalent with alarming rates. In many countries, there has been a call for action to prevent such deaths and to educate staff in the early recognition of suicide risk. A careful MedLine search was used to identify relevant papers dealing with suicide prevention in psychiatric inpatients. This paper reviews this research and the policy recommendations that have been developed for psychiatric hospitals in order to reduce the incidence of suicide in their patients. Results derived from this search indicated that these policy recommendations can be applied to suicide prevention in correctional settings, and it is argued that suicide prevention programs in correctional settings can benefit from the research conducted and the policy recommendations for suicide prevention in psychiatric facilities. In conclusion, the best practices for preventing suicides in jail and prison settings should include the following elements: training programs, screening procedures, communication between staff, documentation, internal resources, and debriefing after a suicide.     

An analysis of self-reported suicide attempts and ideation in a national sample of incarcerated individuals convicted of sexual crimes

ABSTRACT

Suicide is the leading cause of preventable death in US jails and prisons, with rates three to nine times higher than those of the general population. Although suicide in correctional settings has been recognised as a serious problem, the research on suicide among incarcerated individuals remains limited. Individuals who have committed sexual offenses may be at an elevated risk for suicide. Specifically, they have been found to report high rates of hopelessness and depressive mood, and approximately 14% of individuals convicted of sexual offenses have reported a suicide attempt at some point in their lives. Most of these data are based upon official reports and may represent an underreporting of the true prevalence of the problem. The current study provides an analysis of the prevalence and factors associated with self-reported suicidal thoughts and behaviours in a large national sample of individuals convicted of a sexually based crime. Overall, 17.9% of the offenders reported an attempted suicide in their lifetime, 15.1% reported experiencing suicidal ideation but never made an attempt. Risk factors for suicide attempts and ideation for this population are reported. The findings are discussed in the context of suicide prevention and intervention efforts among those who have committed sex offenses.     

Suicide on Death Row

Despite the level of supervision of inmates on death row, their suicide rate is higher than both the male prison population in the United States and the population of males over the age of 14 in free society. This study presents suicide data for death row inmates from 1978 through 2010. For the years 1978 through 2010, suicide rates on death row were higher than that for the general population of males over the age of 15 and for state prisons for all but 2 years.     

Mental health expertise at prison reception

Although screening has become an established procedure in prison health care, some difficulties persist. In attempts to improve this, many local adaptations have been introduced, but few have been evaluated. We introduced an adaptation – mental health expertise (a Community Psychiatric Nurse, CPN) – into the reception area of a busy remand prison, and compared standard and enhanced assessment procedures over a six-month period. Referrals (n = 67) were significantly more likely to be suitable for onward caseworking by the clinical team after a CPN was introduced. The team showed little evidence of the ‘mission creep’ (where teams operating at a secondary level absorb mental health problems at a primary care level) that has been described elsewhere in the literature. Despite its limitations, this evaluation suggests that prison pathways can be improved by relatively inexpensive local initiatives, and that advancing specific mental health expertise into prison reception areas can enhance existing processes.     

Editorial

This article discusses the emergence of the prison system in Sweden during the nineteenth century against the background of the broader context of prison history. Although the number of prisoners had quadrupled already in the first half of the century, it was in the second half that the system was developed. As in many other nations, a heated debate took place on the question of which of the opposing systems – the Philadelphia or the Auburn system – should be chosen. In Sweden this battle between the systems ended with an almost total victory for a Philadelphia‐like system, i.e., on the principle of solitary confinement. During the second half of the nineteenth century, a system built on solitary confinement expanded at the same time as the penal policy took on a more disciplinary character, a tendency that became especially evident at the turn of the century. This expansion continued even after many other nations more or less abandoned solitary confinement. This article argues that this expansion was the result of several factors, the most important being the unprecedented disciplinary possibilities of solitary confinement. The article also argues that this development created a form of ‘successful’ institutions, i.e., well administered, secure and calm institutions, which became one important reason for the remarkably high degree of legitimacy that the Swedish prisons have enjoyed during the twentieth century.     

Suicide by Medication Overdose in Prison: A Study of Three Cases

Suicide is one of the principal causes of mortality in a prison environment. Although suicide by medication overdose is less frequent than suicide by hanging, self‐strangulation, or vein cutting, it raises questions as to how the medications are obtained, particularly in view of the specific organization of the medication circuit in prisons. We present three cases of suicide by medication overdose involving different therapeutic classes with different distribution circuits and review the regulatory requirements and the measures that could be taken to prevent such suicides.     

Self-harming behaviors in prison: a comparison of suicidal processes,self-injurious behaviors,and mixed events

Self-harming behaviors occurring in prison disproportionately consume resources and cause considerable disruption. To date, theoretical paradigms have explained self-injurious behaviors and suicidal processes either via a continuum or dichotomy of self-harm. This current study examines all documented acts of self-harm (n = 1,158) occurring in South Carolina’s 28 prisons over a 50-month period. We test and find support for a tripartite schema of self-harm; differentiated with regard to suicidal processes, self-injurious behaviors, and a ‘mixed group‘ of self-harming behaviors. These groups of behaviors were distinct with regard to situational variables (i.e. body part targeted, injury severity) as well as institutional responses (i.e., medical treatment needed, employment of suicide protocols). Findings indicate that self-injurious behaviors are likely to result in physical injury and/or hospitalizations.     

Correlates of law enforcement suicide in the United States: a comparison with Army and Firefighter suicides using data from the National Violent Death Reporting System

Law Enforcement (LE) officers are considered to be at elevated risk of suicide. This study explored variables associated with LE suicide and the extent they differentiated LE suicides from those within similar occupations considered at risk – Army and Firefighters. Using a public health database of violent deaths, the US National Violent Death Reporting System (NVDRS), the prevalence of and association between seven suicide variables (treatment for a mental health condition, Post Traumatic Stress disorder diagnosis, alcohol and substance abuse, job problems, intimate partner problems) and suicide within LE, Army and Firefighters was computed. Method of suicide and demographic characteristics were also identified. All of the suicide variables were associated with suicide in the three occupation groups. LE suicides were differentiated from Army and Firefighter suicides by being more strongly associated with job problems and suicide by females was more common. Implications for suicide prevention strategies within LE are discussed.     

Pregnancy in prison,Mother and Baby Unit admission and impacts on perinatal depression and ‘quality of life’

Limited research exists on the impact of prison mother and baby unit (MBU) residence. Research in the UK suggests women in MBUs have lower prevalence of mental disorder. Higher rates of mother-child attachment for women in prison nurseries in the US have been reported. Eighty-five pregnant women were interviewed at baseline and 62 followed up in nine different prisons. The Edinburgh Postnatal Depression Scale (EPDS) was used to measure perinatal depression; the World Health Organisation Quality of Life (WHOQOL – BREF), for quality of life; and the Mother-to-Infant Bonding Scale (MIBS) for mother-child bonding. EPDS scores were higher at baseline than follow-up. Women admitted to MBUs had lower EPDS scores at baseline and follow-up, and this reduction was greater than for women not admitted to MBUs. WHO-QOL scores were higher at follow-up than baseline on all domains, except the social domain for those not admitted to MBUs. Findings suggest women with perinatal depression are less likely to be admitted to MBUs, and MBU placement may contribute to a reduction in perinatal depression. Increased QOL-BREF scores at follow-up suggest improved quality of life for all participants. Reduced support post-separation may contribute to lower social domain scores for women not admitted to MBUs.     

Prison labor and recidivism

This study examines recidivism among inmates who participated in prison industry programs during confinement and a comparison group of inmates who were not employed in prison industry. Industry participants had lower recidivism rates than nonparticipants, but when differences between the groups on other characteristics associated with recidivism were controlled, the recidivism rates of participants and nonparticipants were virtually identical. A proportional hazards regression model was estimated that showed that, net of other variables, the effect of prison industry participation on the probability of postrelease felony arrest was small and insignificant. The findings are discussed in the context of existing correctional outcome research and recent developments in prison work programs.     

Prison structure, inmate mortality and suicide risk in Europe

Suicide presents a major complication during imprisonment and greatly contributes to the high mortality rate of prisoners. All international studies have found increased suicide rates among prisoners compared to the general population. This study examines risk factors for suicide and mortality in prisoners using supranational data from the Council of Europe Annual Penal Statistics (Statistiques Penales Annuelles du Conseil du L'Europe or SPACE) from 1997 to 2008. Macrostructural risk factors for prison suicide are analyzed from this supranational data set and the identified indicators are further evaluated on the single country level. Sexual offenders, offenders charged with violent crimes and prisoners sentenced for short- and long-term imprisonment are considered to be at an elevated risk for suicide. In addition, prison mortality is associated with overcrowding.     

College programs in prison and upon reentry for men and women: a literature review

People in prison participating in college education are least likely to recidivate and most likely to be employed after incarceration. Almost no research exists on the collateral – negative and often unanticipated – consequences of a criminal conviction on access to college upon community re-entry. We review these few studies, the existing research on college in prison – with special attention to women’s needs; some new ‘hybrid’ programs with 2 years of college in prison plus 2 years in the community; and the rare studies that interview people applying to college upon re-entry. Their struggles can be overwhelming and require more research and activism.     

Two cases of acute propane/butane poisoning in prison

Hydrocarbon inhalation is seldom chosen as a means to commit suicide. This practice is exclusively a prerogative of the prison population; it is, however, only exceptionally found in this environment. The two cases of lethal inhalation of propane/butane gas observed by us over a very short time occurred in this context. Toxicologic analyses were performed by means of gas chromatography (head space) and revealed a propane/butane mixture in all specimens (heart blood, bile, and urine) except vitreous humor. Although fatal arrhythmia posthydrocarbon gas abuse is well known, the concentrations of the two hydrocarbons were sufficient to induce death by asphyxiation and were distributed (fairly) homogeneously in all biological fluids and organs examined, a parameter permitting one to assume that death occurred within a relatively short period of time. The absence of finding in vitreous humor and the trace amount in urine suggests that both men died very quickly.     

Prison visitation as human ‘right’ or earned ‘privilege’? The differing tales of England/Wales,and Scotland

Prison visitation has been widely recognised as an important feature of a just and humane prison system, providing important benefits for prisoners and their family in maintaining ties. However, emphasis on maintaining prisoner–family ties over the sentence has remained a low priority for the prison service in England and Wales, with prison visits ideologically framed as a ‘privilege’ rather than a ‘right’ for prisoners. This paper contrasts England and Wales with Scotland where a diverging approach to supporting visitation and family contact has been implemented. In Scotland, a strong focus on human rights as a justification for these policies has occurred, in tandem with more palatable historical context of penal welfarism. This paper assesses differences between the two governmental approaches to prison visitation, situated in discussion of some of the broader resettlement outcomes which may be garnered via these policy responses.     

The impact of recidivism and capacity on prison populations

Prison crowding currently poses a serious problem for society. This problem is attributable to a failure to anticipate and plan for the increased numbers of individuals sentenced to prison over the last decade. Crowded prisons have forced many jurisdictions to release prisoners earlier than would have been the case with unlimited prison capacity and to initiate expensive prison construction programs. In this paper, we develop a prison population projection model that extends previous work by considering the impact of limited prison capacity on time served, releases, and future admissions. The model was demonstrated for the State of North Carolina. Results suggest the tradeoffs that exist between prison capacity and punitiveness as measured by time served in prison.Points of view are those of the authors and do not necessarily represent the official position of the U.S. Department of Justice.     

Imprisonment and co-offending: results from a 10-year follow-up study

A recurring question in criminological research is whether prisoners meet new accomplices in prison. This article’s objective is to study co-offending among individuals who have served prison sentences. The frequency of co-offending among individuals who have been in the same prison at the same time will be examined. If gender, age, type of prison, offence type and prior experience of co-offending are significant for this type of co-offending will also be examined. The study population comprised all inmates released from a Swedish prison during a half year in 2001–2002 (n = 3.930). The follow-up period is 10 years. The results show that only 3% of those who have been in the same prison at the same time are suspected of committing offences together subsequent to release. The likelihood of being suspected of committing an offence together following the conclusion of a joint stay in the same prison is higher for those released from a closed prison who are aged 31–40, and who had committed large proportion of their offences together with others prior to the relevant prison sentence. The results suggest that the concept of criminal capital is not important for future co-offending after a joint stay in prison.     

Why do sexual offenders refuse treatment?

Abstract

Theories of offender motivation for treatment have proposed that external factors may be as important as internal factors in creating a state of readiness for treatment. This paper reports an exploratory study of the barriers to treatment for incarcerated sexual offenders. Qualitative and quantitative analysis of interview and questionnaire data from treatment refusers and accepters suggested that refusers were less aware of the effectiveness of treatment, reported seeing negative side effects of treatment in others and felt they had a higher social status in prison which could be damaged by attending treatment. While this study does not demonstrate a causal link between these experiences and the decision to refuse treatment, it seems reasonable to suggest that take-up of treatment could be increased by more sustained efforts to build relationships with treatment refusers and by the provision of accessible information about treatment and its potential benefits.     

Factors associated with desistance from violence in prison: an exploratory study

Desistance from crime has been of increasing interest within criminal justice literature, but desistance from offending behaviour whilst in custodial environments has not yet been investigated. Violence within prison establishments continues to be a significant problem; therefore, this study investigated the factors that are associated with desistance from custodial violence in 63 UK Category C adult male prisoners with a record of violence in prison. Participants completed measures of eight social and subjective factors associated with desistance in community samples. Those who had desisted from prison violence for 12 months or more showed greater levels of pro-social attitudes, agency and resilience than those who persisted in violence. Agency independently predicted desistance and this was particularly the case for younger offenders. Internal shifts appeared to be supported by a positive work environment. It is concluded that in custody an internal shift in perspective is especially important for desistance, and that this can be supported by the social environment. Opportunities to intervene may be greater in younger prisoners. It is recommended that current initiatives in developing agency and positive social interaction, such as Psychologically Informed Planned Environments, are further developed.