Suicidal behavior in jails and prisons in The Netherlands: incidence, characteristics, and prevention.

In most countries, the incidence of suicidal behavior in correctional institutions is higher than in the population at large. In the current study, information was processed on 44 completed suicides (that occurred during the period 1973-1984) and on 198 attempted suicides (1980-1984) by jail and prison inmates in The Netherlands. Demographic, legal, and medical data for victims were compared to similar data for nonsuicidal inmates. Twenty-five inmates who had recently attempted suicide were interviewed, as well as 26 correctional officers and staff members. The majority of suicide completers died by hanging; most attempted suicides were performed impulsively by cutting wrists. Suicidal crises often occurred during the first period of confinement. Inmates born outside The Netherlands and long-term prisoners were high-risk groups. The incarceration of alcohol and/or drug abusers was a complicating issue. Correctional officers and prison staff often viewed suicide attempts as manipulative gestures, although this only partially reflected inmates' true intentions. Several preventive measures are discussed, with special consideration of the identification of suicide risk.