Mental Health and Suicide in Prisons

This chapter will discuss the prison system in relating to mental health and suicide on a global level. Also, to highlight and compare other countries on their strategy towards reducing suicide and try to explain why this is a problem faced by so many countries, despite strategies already in place that might not be successful. Ramesh (2018) explains rates of suicide in prisons are high and conducts a study on risk factors in the prison environment, examining suicide rates in 24 high income countries between 2011-2014.

Comparing general and prison population suicide rates and explored the links between suicide and incarceration rates and prison-related factors. The rates of suicide in these high-income countries remain high, indicating that the current approach is not effective in preventing these deaths. However, research involving the individual level characteristics associated with prisoner suicide has been beneficial. A multilevel approach incorporating risk factors related to the prison environment alongside individual-level risk factors may be necessary to reduce these preventable deaths.

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Ramesh (2018) findings showed that the countries with the lowest rates of prisoner suicide were the USA, Poland and Canada. The countries with the highest rates of prisoner suicide were Norway and France. It became apparent that there was a link between rates of incarceration and rates of prisoner suicide. Suggesting, countries with low incarceration had the highest suicide rates. One explanation for this is that the prisoners being incarcerated are those that have committed more serious or violent offences and, most likely, a large proportion of people suffering from mental illnesses.

And those charged with minor or non-violent offences was given community sentences. Therefore, lower incarceration rates may mean that the prison population is risker and more vulnerable, thereby resulting in higher rates of prisoner suicide. Another issue that goes beyond England and Wales that can contribute to higher risk of suicide is the increased levels of overcrowding. Globally, the prison population continues to rise year on year and, along with continual government constraints on funding, prison environments have undergone changes to accommodate offenders in custody (Ramesh, 2018).

The Institute for Criminal Policy Research reported that in 2017, 119 out of 205 countries reported prisoner populations exceeding their official prison capacity. However, prison suicide is unlikely to have singular associations with environmental factors, such as overcrowding, due to suicide being more complex than that. Although, overcrowding does raise a question of whether the increased rate of overcrowding in prisons, might be associated with rates of prisoner suicide. Due to on-going factors that can contribute towards a prisoner's mental health becoming worse, leading to potential suicide. Contrasting, Ramesh's (2017) study showed no association between rates of overcrowding and rates of prisoner suicide. One possible explanation for this is having a cellmate can be a protective factor against suicide, perhaps due to social interaction. Moreover, if a suicide attempt occurs then the other inmate could quickly call for help which then staff can intervene. As well as, having to share a cell with an inmate, it can also increase their social bonds reducing the risk of prisoners feeling worthless and being bullied due to their vulnerability. An inmate can provide that sense of support throughout the process.

On the other hand, an inmate who suffers from mental health issues could be paired with an individual that abides by the idea of masculinity theory' which could increase the prisoner's mental health due to potentially being bullied. There are many outcomes of having an inmate, and one way to reduce the chance of increasing someone's mental health, is for the prison staff to ensure the individuals that suffer from mental health are paired with an inmate who may not pose further risk. One way to measure this is for research into previous convictions and actions while being in prison to be looked at, in terms of risk they pose on prisoner's. Projektnummer (2010) studied prison suicide in 12 countries. One limitation mentioned is that future work could examine how Australia, New Zealand and Canada manage prisoners and prisons to see if there are systemic differences compared with other countries. One possibility is that their prison health services configured differently.

Previous work has shown that changes in psychiatric services in New Zealand prisons in the 1980's led to a striking increase in suicide. Implying that changes to the provision and delivery of psychiatric care may be important. One reason towards this being an issue, is related to funding and lack of resource's in other countries, also priority of the criminal justice system. However, because this is a global issue, countries need to look at what is being successful and try to adapt different approaches to reduce suicide rates.Overall, this chapter provides a brief analysis on research done to compare multiple countries on their strategies to prevent suicide. And what should be tackled and prioritised from research studies highlighting main factors that contribute towards suicide and to focus on them.