Self-inflicted deaths in Australian prisons

Reducing the rate of self-inflicted deaths in prison has long been a priority for correctional agencies across Australia and internationally. The rate of self-inflicted deaths in the prison population greatly exceeds that of self-inflicted deaths in the community; prisoners represent a particularly vulnerable and high-risk group for suicide. This paper updates Dalton's (1999) national overview of self-inflicted deaths, which analysed data from the Australian Institute of Criminology's (AIC) National Deaths in Custody Program (NDICP) for the period 1980-1998. The current paper analyses data for the period 1999-2013, allowing changes in the prevalence and nature of prison suicides to be examined over a 34-year period.International research shows prison inmates have a higher rate of suicide than their counterparts in the general community, with prison suicide rates typically three to five times those of the general community (Corben 2006; Fazel et al. 2011; Jenkins et al. 2005; Johnston 1991; WHO 2007; Wobeser et al. 2002). Offenders enter the prison system with more risk factors for suicide than those that apply to members of the general community (Konrad et al. 2007; Larney et al. 2012), and remain at elevated risk of suicide following their release (Daigle & Naud 2012; Pratt et al. 2006).Studies examining risk factors for self-inflicted deaths in prisons have found many prisoners who suicided entered the prison system with histories of prior suicide attempts (Fazel et al. 2008; WHO 2007).Across all Australian prisons, 16 percent of those entering prison report intentionally having harmed themselves, while 11 percent had thought of harming themselves in the preceding 12 months (AIHW 2012). Both histories of actual self-harm and thoughts of self-harm were more common among female than male prison entrants, and among non-Indigenous than Indigenous prison entrants (AIHW 2012). A New Zealand study found broadly comparable results, with lower proportions of Maori than European prisoners experiencing thoughts of suicide; Maori prisoners who attempted suicide were, however, more likely to be successful (Simpson 2012).A study of suicidal ideation and suicide attempts in a NSW prison found 34 percent of inmates reported lifetime suicidal ideation and 21 percent had attempted suicide (Larney et al. 2012). Among prisoners in this NSW study who attempted suicide, 58 percent reported a lifetime history of suicidal ideation and suicide attempts. Another NSW study found 68 percent of subjects had a documented history of intentional self-harm (O'Driscoll, Samuels & Zacka 2007), while in South Australia 40 percent of prisoners who suicided had a documented history of previous attempts (Austin, van den Heuvel & Byard 2014). A study in Western Australian prisons found a little over half of all prisoners (56.4% female and 47.3% male) had contemplated suicide at some point in their life (Fleming, Gately & Kraemer 2012). Some 39.5 percent of females had previously attempted suicide, while the same was true for 29.6 percent of males. Female prisoners tended to report their suicidal thoughts had increased while in custody, while males reported a decrease in suicidal thoughts (Fleming, Gately & Kraemer 2012).A similar pattern has been seen overseas. Some 82 percent of prisoners in the UK who suicided had a history of self-harm and suicide attempts while in custody (Shaw, Appleby & Baker 2003). A Dutch prison study found 54 percent of suicide victims in their sample had a history of attempted suicide, including in the community (Blaauw, Kerkhov & Hayes 2005).It is apparent that the life experiences of prisoners, including the experience of imprisonment, increase the risk of suicide both in and out of prison. A study of over 40,000 people released from Queensland prisons found that released women were 14.2 times, and released men 4.8 times, more likely to die from suicide than the general population (Spittal et al. …