Shifting the paradigm of prison suicide prevention through enhanced multi-agency integration and cultural change

This study examines an unusually sustained reduction in suicide rates in a local London prison during the three year period 2008–2011. The likelihood of this reduction taking place by chance was <2:100,000, and its perceived success was such that the prison service recommended an evaluation of its characteristics. This study arose from that recommendation, and it used a retrospective case study multi-method approach (including factor identification, qualitative interviews and triangulation with official documentation) to identify factors which had been associated with the reduced suicide rates. The results endorsed a number of factors which have already been internationally identified as best practice, along with some local innovation factors. Two further pivotal factors emerged through analysis, and they are the key to service improvements. These factors – senior management support for cultural change and cross-professional collaborative working – indicate that positive leadership and multi-agency integration are vital ingredients.