Suicides in Prisons: A Gender Based Perspective

by CAFE Research Volunteer Hyginus Ihemere

INTRODUCTION

The act of self-harm which may occasionally lead to death is one of the unexpected events prison workers and prisoners are confronted with, in their daily lives in a prison environment. Hayes document that suicide is common in jails and prisons but prison suicide tends to attract less attention than jail suicide;¹ and in some cases, there is under-reporting of prison suicides.² This should not be the case because there is loss of human life whenever suicide occurs irrespective of the setting or circumstance. In the effort to shine more light on suicides irrespective of the setting, there has been emphasis by the World Health Organization³ on making suicide prevention an “important international health goal”. The unfortunate side of prison suicide is that it is least likely to receive empathy from the general population than other forms of suicide.⁴ In this article, the author explores brief literature reviews and statistics on prison suicides, with emphasis on male prisoner suicide and their precipitating factors, suicide prevention and some policy reviews and recommendations for stakeholders.

BRIEF LITERATURE REVIEW AND STATISTICS ON SUICIDES IN PRISONS

In Canada, prison suicide is common compared to that of the general population. In a three year review of suicides in Canadian federal prisons by Howard Sapers, he notes that prison suicide occurs at a rate that is five times more than that of the general population.⁵ In the United States of America (U.S.A), similar high suicide rates in prisons and jails have also been reported over the years. In 2011, It was reported that suicide in the U.S. accounted for 5.5% of prison deaths,⁶ and just as in the general population, suicide rate among male prisoners is higher than that of female prisoners.⁷ A review of data on prison suicides from the years 2003-2007 from 12 countries: “Australia, Belgium, Canada, Denmark, England and Wales, Finland, Ireland, Netherlands, New Zealand, Norway, Scotland, and Sweden” showed 810 male suicides and 51 female suicides giving a total of 861 prison suicides.⁸ This high rate of male suicide is alarming and therefore requires appropriate and timely measures in order to ensure a downward trend in male prison suicide rate.

PRECIPITATING FACTORS FOR MALE PRISONER SUICIDE

A number of factors have been documented as having a causal relationship with prison suicides. Some factors are pre-existing prior to incarceration and therefore aggravated by prison confinement, while some others occur as a result of the events in the prison which may be new or unnerving to some prisoners. Pre-existing mental health issues have been linked to some cases of prison suicides. In the Canadian review by Sapers, he found that some of the victims of prison suicide had pre-existing mental health issues.⁵ This agrees with other studies that point to mental health as having a causal relationship with prison suicides.⁹’¹⁰’¹¹ Depression, a common mental health condition is commonly associated with prison suicides.² Some inmates may experience suicidal ideations following periods of isolation from other inmates in the prison, and in the absence of close monitoring, some may end up committing suicide.⁹’¹² Other factors may include the absence of a regular psycho-social support systems such as family and friends following incarceration.⁹’¹¹ Abuse of various forms that may occur in a prison system could also lead to suicidal thoughts and  eventual suicide. Substance abuse among prisoners is associated with suicides in some cases.²’¹¹ Sexual abuse is also very prevalent in the prison environment. Ellenbogen notes that “in the most extreme cases, some inmates would rather take their own lives than subject themselves to the continuous pain and suffering of sexual assault”.¹³ Having highlighted some of the risk factors and/or precipitating factors to prison suicides, these show that prison suicides do not occur randomly rather there are identifiable factors which may directly or indirectly contribute to suicides in prison⁵.

SUICIDE PREVENTION, POLICY REVIEWS AND RECOMMENDATIONS

In view of the fact that suicides amongst male prisoners is one of the  identified issues in the prison system that require greater attention, it is therefore imperative that programs, policies and practices are put in place in the prison system to help quell the tide of self-inflicted male deaths in the prison system. A vital approach will require clearly identifying the precipitation or causal factors, some of which have been discussed above, and instituting appropriate measures to tackle or address them.

The World Health Organization (WHO) highlights the importance of proper staff training on suicide prevention as vital for the success of any suicide prevention program in the correctional facilities, together with pre and post-intake screenings and a subsequent follow up of inmates wherever the need arises.⁹  The importance of such measure was also reiterated in the report  by Sapers for the Correctional Service of Canada (CSC)⁵ since it is the duty of correctional departments to ensure that inmates are safe and alive while incarcerated. Suicides associated with an existing mental health condition must be addressed by having the proper and required number of mental health professionals available to deal with mentally sick inmates.¹⁴ The unfortunate thing is that some mentally sick individuals happen to be incarcerated due to circumstances that may have been related to their illness and we tend to forget that correctional facilities are not Psychiatric hospitals. Improving social interactions in the prison system may be beneficial in mitigating the issue of an isolated living which most prisoners experience.⁹ Since hanging has been identified as the commonest method of suicide in prisons,²’⁴ policies need to be put in place to ensure that inmates with suspected suicidal tendencies are housed in areas free of parts and materials that could support a suicide attempt. This is necessary because despite the clamour for close monitoring and placement of inmates on suicide watch, there continues to be death of prisoners on suicide watch in the various correctional facilities. In some correctional facilities, recreational drugs are occasionally found on prisoners which makes one wonder how illicit drugs continue to pour into prisons despite the existing measures in place to prevent such. Newer methods of ensuring that the prison system is a drug free zone must be implemented and this may include strip searching visitors, since they are usually the main drug  procuring agents for inmates, together with a closer monitoring of prison officials who have in some occasions aided.

CONCLUSION

The death of male inmates from suicides, many of which occur from preventable causes, must be addressed. Stakeholders, including the family members of inmates are therefore required to help make the prison environment safe by applying the necessary safety and preventive measures. Where existing policies are not effective, reviews must be initiated and through these approaches, inmates’ lives may be spared from death arising from self-inflicted harm.

By Hyginus Ihemere

REFERENCES:

  1. Hayes, L. (1995) ‘Prison Suicide: An Overview and Guide to Prevention’, National Institute of Corrections, U.S. Department of Justice(Online). Available from: http://static.nicic.gov/Library/012475.pdf (Accessed 15 August 2016)
  2. Daniel, A, (2006) ‘Preventing Suicide in Prison: A Collaborative Responsibility of Administrative, Custodial, and Clinical Staff’, Journal of American Academy of Psychiatry and the Law Vol. 34:2:165-175(Online). Available from: http://www.jaapl.org/content/34/2/165.full.pdf+html (Accessed 15 August 2016)
  3. World Health Organization (1999) ‘Figures and facts about suicide’, Geneva(Online). Available from: http://apps.who.int/iris/bitstream/10665/66097/1/WHO_MNH_MBD_99.1.pdf (Accessed 15 August 2016)
  4. Olson, R. (2012) ‘InfoExchange 8: Prison Inmate Suicide – Why it Matters’,Centre for Suicide Prevention (Online). Available from: https://www.suicideinfo.ca/LinkClick.aspx?fileticket=ocUQ3DmX17Q%3D&tabid=600 (Accessed 22 August 2016)
  5. Sapers, H. (2014) ‘A Three Year Review of Federal Inmate Suicides (2011–2014)’, Office of the Correctional Investigator of Canada (Online) http://www.oci-bec.gc.ca/cnt/rpt/pdf/oth-aut/oth-aut20140910-eng.pdf (Accessed 15 August 2016)
  6. Smith, A. (2013) ‘Suicides kill more inmates than homicide, overdoses, accidents combined’, NBCNEWS September 04 (Online). Available from: http://www.nbcnews.com/news/other/suicides-kill-more-inmates-homicide-overdoses-accidents-combined-f8C11072563 (Accessed 15 August 2016)
  7. Canadian Correctional Services (2015) ‘FORUM on Corrections Research’, Volume 4, No. 3 (Online). Available from: http://www.csc-scc.gc.ca/research/forum/e043/e043i-eng.shtml (Accessed 15 August 2016)
  8. Fazel, S., Grann, M., Kling, B. and Hawton, K. (2011) ‘Prison suicide in 12 countries: an ecological study of 861 suicides during 2003-2007’, Social Psychiatry and Psychiatric Epidemiology  Vol. 46(3):191-195(Online). Available from: https://www.kriminalvarden.se/globalassets/publikationer/forskningsrapporter/prison-suicide-in-12-countriespdf  (Accessed 22 August 2016)
  9. World Health Organization (2007) ‘Preventing Suicide in Jails and Prisons’,Department of Mental Health and Substance Abuse World Health Organization, International Association for Suicide Prevention (Online). Available from: http://www.who.int/mental_health/prevention/suicide/resource_jails_prisons.pdf (Accessed 22 August 2016)
  10. Shaw, J., Baker, D., Hunt, I., Moloney, A. and Appleby, L. (2004) ‘Suicide by Prisoners: National Clinical Survey’, The British Journal of Psychiatry, 184 (3) 263-267(Online) Available from: http://bjp.rcpsych.org/content/bjprcpsych/184/3/263.full.pdf (Accessed 22 August 2016)
  11. Way, B., Miraglia, R., Sawyer, D., Beer, R. and Eddy, J. (2005) ‘Factors related to suicide in New York state prisons’, International Journal of Law and Psychiatry Volume 28, Issue 3, May–June 2005, P. 207–221(Online). Available from: http://www.sciencedirect.com/science/article/pii/S0160252705000427 (Accessed 22 August 2016)
  12. Felthous, A. (1997) ‘Does “isolation” cause jail suicides?’ The journal of the American Academy of Psychiatry and the Law, Vol. 25(3):285-294(Online). Available from: http://www.ncbi.nlm.nih.gov/pubmed/9323655 (Accessed 22 August 2016)
  13. Ellenbogen, P. (2009) ‘Beyond the Border: A Comparative Look at Prison Rape in the United States and Canada’, Columbia Journal of Law and Social Problems Vol. 43(3) p. 335-372(Online). Available from: http://www.columbia.edu/cu/jlsp/pdf/Spring2008/02Ellenbogen42.3(revised).pdf (Accessed: 29 August 2016)
  14. Hayes, L. (2013) ‘Suicide prevention in correctional facilities: reflections and next steps’, International Journal of Law and Psychiatry Vol. 36(3-4):188-194(Online). Available from: http://www.ncianet.org/suicide-prevention-in-correctional-facilities-reflections-and-next-steps/ (Accessed: 29 August 2016)