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. 2021 Oct;36(10):1075-1083.
doi: 10.1007/s10654-021-00782-0. Epub 2021 Aug 24.

Suicide in prison and after release: a 17-year national cohort study

Anne Bukten  1   2 , Marianne Riksheim Stavseth  3   4
Affiliations

Suicide in prison and after release: a 17-year national cohort study

Anne Bukten et al. Eur J Epidemiol. 2021 Oct.

Abstract

Background: People in prison have an extremely high risk of suicide. The aim of this paper is to describe all suicides in the Norwegian prison population from 2000 to 2016, during and following imprisonment; to investigate the timing of suicides; and to investigate the associations between risk of suicide and types of crime.

Methods: We used data from the Norwegian Prison Release study (nPRIS) including complete national register data from the Norwegian Prison Register and the Norwegian Cause of Death Register in the period 1.1.2000 to 31.12.2016, consisting of 96,856 individuals. All suicides were classified according to ICD-10 codes X60-X84. We calculated crude mortality rates (CMRs) per 100,000 person-years and used a Cox Proportional-Hazards regression model to investigate factors associated with suicide during imprisonment and after release reported as hazard ratios (HRs).

Results: Suicide accounted for about 10% of all deaths in the Norwegian prison population and was the leading cause of death in prison (53% of in deaths in prison). The CMR per 100,000 person years for in-prison suicides was 133.8 (CI 100.5-167.1) and was ten times higher (CMR = 1535.0, CI 397.9-2672.2) on day one of incarceration. Suicides after release (overall CMR = 82.8, CI 100.5-167.1) also peaked on day one after release (CMR = 665.7, CI 0-1419.1). Suicide in prison was strongly associated with convictions of homicide (HR 18.2, CI 6.5-50.8) and high-security prison level (HR 15.4, CI 3.6-65.0). Suicide after release was associated with convictions of homicide (HR 3.1, CI 1.7-5.5).

Conclusion: There is a high risk of suicide during the immediate first period of incarceration and after release. Convictions for severe violent crime, especially homicide, are associated with increased suicide risk, both in prison and after release.

Keywords: Convictions; Criminal justice; Mental health; Mortality; Prison; Release; Suicide.

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Conflict of interest statement

The authors declare that they have no competing interest.

Figures

Fig. 1
Fig. 1
Crude mortality rates per main conviction, by in-prison suicides (n=62) and suicides after release (n=749), 2000–2016
Fig. 2
Fig. 2
Crude mortality rates for different time units after imprisonment or after release, by in-prison suicides (n=62) and suicides after release (n=749), 2000–2016
See this image and copyright information in PMC

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