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Kent H, Magner-Parsons B, Leckie G, Dulgar T, Lusiandari A, Hogarth L, Williams H, Kirby A. Profiles of vulnerability for suicide and self-harm in UK prisoners: Neurodisability, mood disturbance, substance use, and bullying. PLoS One 2024; 19:e0296078. [PMID: 38170719 PMCID: PMC10763929 DOI: 10.1371/journal.pone.0296078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 11/27/2023] [Indexed: 01/05/2024] Open
Abstract
Screening for vulnerability factors associated with historic suicidality and self-harm on entry to prison is critical to help prisons understand how to allocate extremely limited mental health resources. It has been established that having previous suicide attempts increases odds of future suicidality and self-harm in prison. We utilised administrative screening data from 665 adult male prisoners on entry to a category B prison in Wales, UK, collected using the Do-IT Profiler. This sample represents 16% of all prisoners who entered that prison during a 26-month period. 12% of prisoners reported a history of attempted suicide, 11% reported historic self-harm, and 8% reported a history of both. Historic traumatic brain injury and substance use problems were associated with a 3.3- and 1.9- times increased odds of a historic suicide attempt, respectively, but no significant increased risk of historic self-harm (95% CI: 1.51-6.60 and 1.02-3.50). However, those who were bullied at school had 2.7 times increased odds of reporting a history of self-harm (95% CI: 1.63-6.09). The most salient risk factors associated with both historic suicide and self-harm were higher levels of functional neurodisability (odds ratio 0.6 for a 1 standard deviation change in score, 95% CI: 0.35-0.75), and mood disturbance (odds ratio 2.1 for a 1 standard deviation change in score, 95% CI: 1.26-3.56). Therefore, it could be beneficial for prisons to screen for broader profiles of needs, to better understand how to provide appropriate services to prisoners vulnerable to suicide and self-harm. Multidisciplinary care pathways for prisoner mental health interventions are important, to account for complex multimorbidity. Adaptations may be needed for mental health interventions to be appropriate for, for example, a prisoner with a brain injury. Understanding this broad profile of vulnerability could also contribute to more compassionate responses to suicide and self-harm from prison staff.
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Affiliation(s)
- Hope Kent
- Department of Psychology, Washington Singer Laboratories, University of Exeter, Devon, United Kingdom
| | - Bella Magner-Parsons
- Department of Psychology, Washington Singer Laboratories, University of Exeter, Devon, United Kingdom
| | - George Leckie
- School of Education, University of Bristol, Bristol, United Kingdom
| | - Tuna Dulgar
- Department of Psychology, Washington Singer Laboratories, University of Exeter, Devon, United Kingdom
| | - Anggita Lusiandari
- Department of Psychology, Washington Singer Laboratories, University of Exeter, Devon, United Kingdom
| | - Lee Hogarth
- Department of Psychology, Washington Singer Laboratories, University of Exeter, Devon, United Kingdom
| | - Huw Williams
- Department of Psychology, Washington Singer Laboratories, University of Exeter, Devon, United Kingdom
| | - Amanda Kirby
- Emeritus Professor, School of Education, University of South Wales, Wales, United Kingdom
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Betancourt JA, Dolezel DM, Shanmugam R, Pacheco GJ, Stigler Granados P, Fulton LV. The Health Status of the US Veterans: A Longitudinal Analysis of Surveillance Data Prior to and during the COVID-19 Pandemic. Healthcare (Basel) 2023; 11:2049. [PMID: 37510490 PMCID: PMC10378995 DOI: 10.3390/healthcare11142049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 07/11/2023] [Accepted: 07/15/2023] [Indexed: 07/30/2023] Open
Abstract
Chronic diseases affect a disproportionate number of United States (US) veterans, causing significant long-term health issues and affecting entitlement spending. This longitudinal study examined the health status of US veterans as compared to non-veterans pre- and post-COVID-19, utilizing the annual Center for Disease Control and Prevention (CDC) behavioral risk factor surveillance system (BRFSS) survey data. Age-adjusted descriptive point estimates were generated independently for 2003 through 2021, while complex weighted panel data were generated from 2011 and onward. General linear modeling revealed that the average US veteran reports a higher prevalence of disease conditions except for mental health disorders when compared to a non-veteran. These findings were consistent with both pre- and post-COVID-19; however, both groups reported a higher prevalence of mental health issues during the pandemic years. The findings suggest that there have been no improvements in reducing veteran comorbidities to non-veteran levels and that COVID-19 adversely affected the mental health of both populations.
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Affiliation(s)
- Jose A Betancourt
- School of Health Administration, Texas State University, San Marcos, TX 78666, USA
| | - Diane M Dolezel
- Department of Health Information Management, Texas State University, Round Rock, TX 78665, USA
| | - Ramalingam Shanmugam
- School of Health Administration, Texas State University, San Marcos, TX 78666, USA
| | - Gerardo J Pacheco
- School of Health Administration, Texas State University, San Marcos, TX 78666, USA
| | | | - Lawrence V Fulton
- Woods College of Advancing Studies, Boston College, Chestnut Hill, MA 02467, USA
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