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Stoliker BE, Abderhalden FP. People in Custody With a Suicidal History: An Ideation-to-Action Perspective Involving Individuals Incarcerated in Two U.S. Jails. Arch Suicide Res 2021; 27:231-245. [PMID: 34582321 DOI: 10.1080/13811118.2021.1982095] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Despite high suicide mortality in U.S. jails, little is known about the cognitive (ideation) and behavioral (attempt) spectrum of suicide risk in this population. Identifying factors associated with the development of suicidal ideation, as well as the translation of thoughts to acts of suicide, is important for suicide prevention. METHOD Using data from a cross-sectional study conducted in 2018-2019, we investigated suicidal ideation and attempt among 548 individuals incarcerated in jail in the United States. Specifically, we compared those with suicidal ideation (n = 212) to those without suicidal ideation (n = 336), as well as compared those who had experienced suicidal ideation and attempted suicide (n = 114) to those who thought about suicide without making an attempt (n = 98), on a range of sociodemographic and clinical factors. RESULTS Over one-third (38.7%) of participants had a history of suicidal ideation, whereas 23.3% had attempted suicide. In the adjusted analyses, a family history of suicide (OR = 2.09), drug use (OR = 2.26), social support (OR = 0.61), and self-harm (OR = 24.93) were linked to suicidal ideation. No wish to live (OR = 5.26) and interpersonal violence while intoxicated (OR = 2.41) were associated with the progression from suicidal ideation to a suicide attempt. CONCLUSIONS Consistent with extant theoretical and empirical work, findings suggest that factors linked to the development of suicidal cognitions differ from those underlying the progression from suicidal ideation to a (non-lethal) suicide attempt.HIGHLIGHTSSuicidal risk is particularly high among individuals who are incarcerated in jail.Factors linked to suicidal ideation differ from those underlying acts of suicide.Ideators and attempters possess a different set of targets for intervention.
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Stoliker BE, Verdun-Jones SN, Vaughan AD. Psychological and Sociological Perspectives on Suicide: A Multi-Level Examination of Suicidal Thoughts and Attempted Suicide among Prisoners. Arch Suicide Res 2021; 25:596-628. [PMID: 32169027 DOI: 10.1080/13811118.2020.1738294] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Informed by psychological and sociological perspectives, the present study aimed to improve knowledge on the nature of suicidal thoughts and attempted suicide among adult prisoners. Analyzing data from a nationally representative sample of 18,185 prisoners housed in 287 state and 39 federal prisons across the United States highlight: (a) key micro-level factors associated with suicidal thoughts and attempted suicide, along with some distinct predictive patterns for suicidal thoughts versus attempted suicide; (b) similarities and differences between male and female prisoners concerning the predictive patterns of suicidal thoughts and attempted suicide; (c) the relationship between macro-level prison characteristics and prisoner suicidality. Discussion points toward a direction for future research on prisoner suicidality, as well as recommendations for managing at-risk prisoners.
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Zheng F, Wu W, Wang L, Ngoubene-Atioky AJ, Chen L. Childhood trauma and suicidal ideation among Chinese female prisoners: The mediating roles of negative emotions and social support. PERSONALITY AND INDIVIDUAL DIFFERENCES 2021. [DOI: 10.1016/j.paid.2020.110405] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Mitchell SM, Brown SL, Scanlon F, Swogger MT, Delgado D, Ventura MI, Bolaños AD, Morgan RD. Lifetime History of Suicide Attempts among Not Guilty by Reason of Insanity State Hospital Inpatients: The Roles of past Harmful Substance Use and Current Social Support. INTERNATIONAL JOURNAL OF FORENSIC MENTAL HEALTH 2020; 19:341-353. [PMID: 33223964 PMCID: PMC7678914 DOI: 10.1080/14999013.2020.1775326] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
This study tested current perceived social support (CPSS) as a moderator of the relation between previous substance use (PSU) and lifetime suicide attempt (SA) history among 200 NGRI inpatients. Results indicated no significant CPSS main effect. PSU was associated with greater odds of multiple prior lifetime SA. Moderation indicated those low in PSU but high in CPSS were least likely to report multiple prior lifetime SA. Conversely, NGRI inpatients with high CPSS and high PSU were most likely to report multiple lifetime SA. Our study suggests CPSS and PSU assessments may inform suicide risk assessments and interventions among NGRI inpatients.
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Affiliation(s)
- Sean M. Mitchell
- Department of Psychiatry, University of Rochester Medical Center, Rochester, Newyork
- Department of Psychological Sciences, Texas Tech University, Lubbock, Texas
| | - Sarah L. Brown
- Department of Psychological Sciences, Texas Tech University, Lubbock, Texas
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Faith Scanlon
- Department of Psychological Sciences, Texas Tech University, Lubbock, Texas
| | - Marc T. Swogger
- Department of Psychiatry, University of Rochester Medical Center, Rochester, Newyork
| | - Darci Delgado
- Division of Clinical Operations, California Department of State Hospitals, Sacramento, California
| | - Maria I. Ventura
- Division of Clinical Operations, California Department of State Hospitals, Sacramento, California
- Department of Psychiatry, University of California, Davis, Sacramento, California
| | - Angelea D. Bolaños
- Department of Psychological Sciences, Texas Tech University, Lubbock, Texas
| | - Robert D. Morgan
- Department of Psychological Sciences, Texas Tech University, Lubbock, Texas
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Mundt AP, Baranyi G, Gabrysch C, Fazel S. Substance Use During Imprisonment in Low- and Middle-Income Countries. Epidemiol Rev 2018; 40:70-81. [PMID: 29584860 PMCID: PMC5982797 DOI: 10.1093/epirev/mxx016] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2017] [Accepted: 11/07/2017] [Indexed: 12/29/2022] Open
Abstract
Substance use disorders are among the most common health problems of people involved with the criminal justice system. Scaling up addiction services in prisons is a global public health and human rights challenge, especially in poorly resourced countries. We systematically reviewed the prevalence of substance use in prison populations in low- and middle-income countries. We searched for studies reporting prevalence rates of nicotine, alcohol, illicit drug, and injection drug use during imprisonment in unselected samples of imprisoned people in low- and middle-income countries. Data meta-analysis was conducted and sources of heterogeneity were examined by meta-regression. Prevalence of nicotine use during imprisonment ranged from 5% to 87%, with a random-effects pooled estimate of 56% (95% confidence interval (CI): 45, 66) with significant geographical heterogeneity. Alcohol use varied from 1% to 76% (pooled prevalence, 16%, 95% CI: 9, 25). Approximately one-quarter of people (25%; 95% CI: 17, 33; range, 0–78) used illicit drugs during imprisonment. The prevalence of injection drug use varied from 0% to 26% (pooled estimate, 1.6%, 95% CI: 0.8, 3.0). Lifetime substance use was investigated in secondary analyses. The high prevalence of smoking in prison suggests that policies regarding smoking need careful review. Furthermore, the findings underscore the importance of timely, scalable, and available treatments for alcohol and illegal drug use by people involved with the criminal justice system.
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Affiliation(s)
- Adrian P Mundt
- Medical Faculty, Universidad Diego Portales, Santiago, Chile.,Medical School, Universidad San Sebastián, Puerto Montt, Chile
| | - Gergo Baranyi
- Center for Research on Environment Society and Health, School of Geosciences, University of Edinburgh, Edinburgh, United Kingdom.,Institute and Polyclinic for Occupational and Social Medicine, Technische Universität Dresden, Germany
| | - Caroline Gabrysch
- Department of Psychiatry and Psychotherapy Campus Mitte, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Seena Fazel
- Department of Psychiatry, Oxford University, Oxford, United Kingdom
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6
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Prison suicide in female detainees in Germany 2000-2013. J Forensic Leg Med 2016; 44:68-71. [PMID: 27636654 DOI: 10.1016/j.jflm.2016.08.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2016] [Revised: 08/21/2016] [Accepted: 08/28/2016] [Indexed: 11/23/2022]
Abstract
Specific risk factors for suicide among female prisoners were examined using an exhaustive sample of all suicides in German prisons between 2000 and 2013. The rate of prison suicide was lower among female (53,5/100,000) than among male prisoners (101/100,000). Differences between the genders regarding the various risk factors for prison suicide are few. Significant differences were observed only for bullying among men and higher percentages of drug withdrawal syndrome among women. Factors specific to the prison setting that contribute to suicide risk in incarcerated women should be examined.
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Schaefer KE, Esposito-Smythers C, Tangney JP. Suicidal ideation in a United States jail: Demographic and psychiatric correlates. THE JOURNAL OF FORENSIC PSYCHIATRY & PSYCHOLOGY 2016; 27:698-704. [PMID: 27660559 PMCID: PMC5028132 DOI: 10.1080/14789949.2016.1193886] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Suicidal behavior is a significant problem in United States jails. Suicidal ideation (SI) is an established precursor to suicidal behavior in incarcerated populations. No studies to date have examined the prevalence of SI or its correlates in a mixed gender U.S. jail sample. The purpose of the present study was to document rates of SI in a mixed gender jail sample and examine socio-demographic and psychiatric correlates. This study of 511 jail inmates found that approximately 16% of participants reported clinically significant SI upon incarceration. White participants, suicide attempters, and those with a psychiatric diagnosis history endorsed greater SI. Reported SI did not differ by sex and was not correlated with age. Clinically, results indicate that screening for SI in jail samples is necessary to identify high-risk individuals for intervention to prevent suicidal behavior.
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Affiliation(s)
- Karen E. Schaefer
- George Mason University, 4400 University Drive, Fairfax VA 22030, USA
- Corresponding author at: Department of Psychology, George Mason University, Mail Stop 3F5, Fairfax, VA 22030, Phone: (610) 308-6995, Fax: (703) 993-1359,
| | | | - June P. Tangney
- George Mason University, 4400 University Drive, Fairfax VA 22030, USA
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Gooding P, Tarrier N, Dunn G, Shaw J, Awenat Y, Ulph F, Pratt D. The moderating effects of coping and self-esteem on the relationship between defeat, entrapment and suicidality in a sample of prisoners at high risk of suicide. Eur Psychiatry 2015; 30:988-94. [PMID: 26497469 PMCID: PMC4682192 DOI: 10.1016/j.eurpsy.2015.09.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 08/30/2015] [Accepted: 09/05/2015] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Research is sparse which examines pathways to suicide, and resilience to suicide, in people who are particularly vulnerable to suicide, for example, prison inmates. The purpose of this study was to examine the ways in which perceptions of self-esteem and coping ability interacted with defeat and entrapment to both amplify suicidal thoughts and feelings, and to act as a buffer against suicidal thoughts and feelings. METHODS Participants were 65 male prisoners at high risk of suicide. A cross-sectional questionnaire design was used. Questionnaire measures of depression, defeat, entrapment, self-esteem, coping ability and suicidal probability were administered. RESULTS For the hopelessness component of the suicide probability measure, high levels of coping ability together with low levels of defeat resulted in the lowest levels of suicidality indicative of a resilience factor. In contrast, low levels of coping skills together with high levels of entrapment were a high risk factor for this hopelessness component of suicide. This pattern of results pertained when controlling for depression levels. CONCLUSIONS This is the first study to examine interactions between defeat, entrapment and appraisals of self-esteem and coping ability. Therapeutic interventions would benefit from boosting perceptions and appraisals of coping ability, in particular, in people who are at high risk for suicide.
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Affiliation(s)
- P Gooding
- School of Psychological Sciences, University of Manchester, Manchester, UK; Manchester Health Science Centre (MAHSC), Manchester, UK.
| | - N Tarrier
- School of Psychological Sciences, University of Manchester, Manchester, UK; Department of Psychology, Institute of Psychiatry, King's College, London, UK
| | - G Dunn
- Institute of Population Health, University of Manchester, Manchester, UK; Manchester Health Science Centre (MAHSC), Manchester, UK
| | - J Shaw
- Manchester Health Science Centre (MAHSC), Manchester, UK; Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, UK
| | - Y Awenat
- School of Psychological Sciences, University of Manchester, Manchester, UK; Manchester Health Science Centre (MAHSC), Manchester, UK
| | - F Ulph
- School of Psychological Sciences, University of Manchester, Manchester, UK; Manchester Health Science Centre (MAHSC), Manchester, UK
| | - D Pratt
- School of Psychological Sciences, University of Manchester, Manchester, UK; Manchester Health Science Centre (MAHSC), Manchester, UK; Manchester Mental Health and Social Care NHS Trust, Manchester, UK
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Nicholls TL, Crocker AG, Seto MC, Wilson CM, Charette Y, Côté G. The national trajectory project of individuals found not criminally responsible on account of mental disorder. Part 5: how essential are gender-specific forensic psychiatric services? CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2015; 60:135-45. [PMID: 25886689 PMCID: PMC4394713 DOI: 10.1177/070674371506000308] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Accepted: 10/01/2014] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To state the sociodemographic characteristics, mental health histories, index offence characteristics, and criminal histories of male and female forensic psychiatric patients. Clinicians and researchers advocate that mental health and criminal justice organizations implement gender-specific services; however, few studies have sampled forensic patients to evaluate the extent to which men's and women's treatment and management needs are different. METHOD Data were collected from Review Board files from May 2000 to April 2005 in the 3 largest Canadian provinces. Using official criminal records, participants were followed for 3 to 8 years, until December 2008. The final sample comprised 1800 individuals: 15.6% were women and 84.4% were men. RESULTS There were few demographic differences, but women had higher psychosocial functioning than men. Both men and women had extensive mental health histories; women were more likely diagnosed with mood disorders and PDs and men were more likely diagnosed with schizophrenia spectrum disorders and SUDs. The nature of the index offence did not differ by gender, except women were more likely to have perpetrated murders and attempted murders. For offences against a person, women were more likely to offend against offspring and partners and less likely to offend against strangers, compared with men. Women had significantly less extensive criminal histories than men. CONCLUSIONS Not criminally responsible on account of mental disorder-accused women have a distinct psychosocial, clinical, and criminological profile from their male counterparts, which may suggest gender-specific assessment, risk management, and treatment in forensic services could benefit patients. The findings are also consistent with traditional models (Risk-Need-Responsivity) and ultimately demonstrate the importance of individual assessment and client-centred services.
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Affiliation(s)
- Tonia L Nicholls
- Associate Professor, Department of Psychiatry, University of British Columbia, Vancouver, British Columbia; Senior Research Fellow, Forensic Psychiatric Services Commission, BC Mental Health & Substance Use Services, Coquitlam, British Columbia
| | - Anne G Crocker
- Associate Professor, Department of Psychiatry, McGill University, Montreal, Quebec; Associate Director, Policy and Knowledge Exchange, Douglas Mental Health University Institute Research Centre, Montreal, Quebec
| | - Michael C Seto
- Director of Forensic Rehabilitation Research, Royal Ottawa Health Care Group, Brockville, Ontario
| | - Catherine M Wilson
- Post-doctoral Research Fellow, University of British Columbia and British Columbia Forensic Psychiatric Services Commission, BC Mental Health & Substance Use Services, Coquitlam, British Columbia
| | - Yanick Charette
- Post-doctoral Fellow, Department of Sociology, Yale University, New Haven, Connecticut
| | - Gilles Côté
- Professor, Department of Psychology, Université du Québec à Trois-Rivières, Trois-Rivières, Quebec; Director, Philippe-Pinel Institute Research Centre, Montreal, Quebec
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Witt K, Hawton K, Fazel S. The relationship between suicide and violence in schizophrenia: analysis of the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) dataset. Schizophr Res 2014; 154:61-7. [PMID: 24581550 PMCID: PMC3988953 DOI: 10.1016/j.schres.2014.02.001] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Revised: 01/20/2014] [Accepted: 02/02/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Suicide and violence often co-occur in the general population as well as in mentally ill individuals. Few studies, however, have assessed whether these suicidal behaviors are predictive of violence risk in mental illness. AIMS The aim of this study is to investigate whether suicidal behaviors, including suicidal ideation, threats, and attempts, are significantly associated with increased violence risk in individuals with schizophrenia. METHOD Data for these analyses were obtained from the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) trial, a randomized controlled trial of antipsychotic medication in 1460 adults with schizophrenia. Univariate Cox regression analyses were used to calculate hazard ratios (HRs) for suicidal ideation, threats, and attempts. Multivariate analyses were conducted to adjust for common confounding factors, including: age, alcohol or drug misuse, major depression, antisocial personality disorder, depression, hostility, positive symptom, and poor impulse control scores. Tests of discrimination, calibration, and reclassification assessed the incremental predictive validity of suicidal behaviors for the prediction of violence risk. RESULTS Suicidal threats and attempts were significantly associated with violence in both males and females with schizophrenia with little change following adjustment for common confounders. Only suicidal threats, however, were associated with a significant increase in incremental validity beyond age, diagnosis with a comorbid substance use disorder, and recent violent behavior. CONCLUSIONS Suicidal threats are independently associated with violence risk in both males and females with schizophrenia, and may improve violence risk prediction.
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Affiliation(s)
- Katrina Witt
- University of Oxford, Department of Psychiatry, Warneford Hospital, Oxford OX3 7JX, UK
| | - Keith Hawton
- Centre for Suicide Research, University of Oxford, Department of Psychiatry, Warneford Hospital, Oxford OX3 7JX, UK
| | - Seena Fazel
- University of Oxford, Department of Psychiatry, Warneford Hospital, Oxford OX3 7JX, UK.
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Hawton K, Linsell L, Adeniji T, Sariaslan A, Fazel S. Self-harm in prisons in England and Wales: an epidemiological study of prevalence, risk factors, clustering, and subsequent suicide. Lancet 2014; 383:1147-54. [PMID: 24351319 PMCID: PMC3978651 DOI: 10.1016/s0140-6736(13)62118-2] [Citation(s) in RCA: 142] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Self-harm and suicide are common in prisoners, yet robust information on the full extent and characteristics of people at risk of self-harm is scant. Furthermore, understanding how frequently self-harm is followed by suicide, and in which prisoners this progression is most likely to happen, is important. We did a case-control study of all prisoners in England and Wales to ascertain the prevalence of self-harm in this population, associated risk factors, clustering effects, and risk of subsequent suicide after self-harm. METHODS Records of self-harm incidents in all prisons in England and Wales were gathered routinely between January, 2004, and December, 2009. We did a case-control comparison of prisoners who self-harmed and those who did not between January, 2006, and December, 2009. We also used a Bayesian approach to look at clustering of people who self-harmed. Prisoners who self-harmed and subsequently died by suicide in prison were compared with other inmates who self-harmed. FINDINGS 139,195 self-harm incidents were recorded in 26,510 individual prisoners between 2004 and 2009; 5-6% of male prisoners and 20-24% of female inmates self-harmed every year. Self-harm rates were more than ten times higher in female prisoners than in male inmates. Repetition of self-harm was common, particularly in women and teenage girls, in whom a subgroup of 102 prisoners accounted for 17,307 episodes. In both sexes, self-harm was associated with younger age, white ethnic origin, prison type, and a life sentence or being unsentenced; in female inmates, committing a violent offence against an individual was also a factor. Substantial evidence was noted of clustering in time and location of prisoners who self-harmed (adjusted intra-class correlation 0·15, 95% CI 0·11-0·18). 109 subsequent suicides in prison were reported in individuals who self-harmed; the risk was higher in those who self-harmed than in the general prison population, and more than half the deaths occurred within a month of self-harm. Risk factors for suicide after self-harm in male prisoners were older age and a previous self-harm incident of high or moderate lethality; in female inmates, a history of more than five self-harm incidents within a year was associated with subsequent suicide. INTERPRETATION The burden of self-harm in prisoners is substantial, particularly in women. Self-harm in prison is associated with subsequent suicide in this setting. Prevention and treatment of self-harm in prisoners is an essential component of suicide prevention in prisons. FUNDING Wellcome Trust, National Institute for Health Research, National Offender Management Service, and Department of Health.
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Affiliation(s)
- Keith Hawton
- Centre for Suicide Research, Department of Psychiatry, University of Oxford, Oxford, UK
| | - Louise Linsell
- Clinical Trials Unit, National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK
| | - Tunde Adeniji
- Equality, Rights and Decency Group, National Offender Management Service, Ministry of Justice, London, UK
| | - Amir Sariaslan
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Seena Fazel
- Department of Psychiatry, University of Oxford, Oxford, UK.
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