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Preventing Suicide in Prison: A Collaborative Responsibility of Administrative, Custodial, and Clinical Staff


Suicide is a sentinel event in prison, and preventive efforts reflect the adequacy and comprehensiveness of mental health, psychiatric, custodial, and administrative services in a correctional system. This article reviews the literature on suicide in prison during the past three decades and identifies the pattern and occurrence of risk factors. These risk factors are classified as demographic, institutional, and clinical. Based on this review, the author outlines specific administrative, custodial, and clinical steps and procedures that form the basis of a comprehensive suicide-prevention program that can be implemented in small and large systems. The author recognizes the limitations of staff availability, the budget constraints, and the ineffectiveness of efforts to prevent suicides that occur without any warning. Ultimately, a prevention program is the collective responsibility of administrative, custodial, and clinical staff.

The study of suicide in prisons has increased dramatically since the 1980s. Factors contributing to this increase include the rising frequency of suicide in prisons; class action lawsuits related to suicide; deinstitutionalization of the mentally ill; and lack of community-based programs for mentally ill criminals.1–6 Legal reforms, prison diversionary programs, and regional differences in suicide rates7 have also influenced the research.

..For the remainder of this paper: by Anasseril E. Daniel, MD, Daniel Correctional Psychiatric Services, 33 E. Broadway, Suite 115, Columbia, MO 65203

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