Francesco Domenico Fritz1,2, Seena Fazel3, Andrés Benavides Salcedo4, Paulette Henry5, Guillermo Rivera Arroyo6, Julio Torales7, Natalia Trujillo Orrego8, Freddy Vásquez9, Adrian P Mundt10,11. 1. Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany. 2. Department of Psychiatry, Hospital Clínico Universidad de Chile, Santiago, Chile. 3. Department of Psychiatry, University of Oxford, Oxford, UK. 4. Ministry of Public Health, Quito, Ecuador. 5. Department of Sociology, University of Guyana, Georgetown, Guyana. 6. Department of Psychology, Private University of Santa Cruz de la Sierra, Santa Cruz de la Sierra, Bolivia. 7. Department of Psychiatry, School of Medical Sciences, National University of Asunción, San Lorenzo, Paraguay. 8. Mental Health Research Group, National Faculty of Public Health, University of Antioquia, Medellin, Colombia. 9. Suicide Prevention Program, National Institute for Mental Health, Lima, Peru. 10. Medical Faculty, Universidad Diego Portales, Santiago, Chile. adrian.mundt@mail.udp.cl. 11. Medical Faculty, Universidad San Sebastián, Puerto Montt, Chile. adrian.mundt@mail.udp.cl.
Abstract
PURPOSE: Although suicide rates of prison populations and incidence factors have been reported for high-income countries, data from low- and middle-income regions are lacking. The purpose of the study was to estimate suicide rates among prison populations in South America, to examine prison-related factors, and to compare suicide rates between prison and general populations. METHODS: In this observational study, we collected the numbers of suicides in prison, rates of prison occupancy, and incarceration rates from primary sources in South America between 2000 and 2017. We compared suicide rates among prisoners with incidence rates in the general populations by calculating incidence rate ratios. We assessed the effect of gender, year, incarceration rates and occupancy on suicide rates in the prison populations using regression analyses. RESULTS: There were 1324 suicides reported during 4,437,591 person years of imprisonment between 2000 and 2017 in 10 South American countries. The mean suicide rate was 40 (95% CI 16-65) per 100,000 person years for male and female genders combined. The pooled incidence rate ratio of suicide between prison and general populations was 3.9 (95% CI 3.1-5.1) for both genders combined, 2.4 (95% CI 1.9-3.1) for men and a higher ratio in women (13.5, 95% CI 6.9-26.9). High occupancies of prisons were associated with lower incidence of suicide (β = - 58, 95% CI - 108.5 to - 7.1). CONCLUSIONS: Suicides during imprisonment in South America are an important public health problem. Suicide prevention strategies need to target prison populations.
PURPOSE: Although suicide rates of prison populations and incidence factors have been reported for high-income countries, data from low- and middle-income regions are lacking. The purpose of the study was to estimate suicide rates among prison populations in South America, to examine prison-related factors, and to compare suicide rates between prison and general populations. METHODS: In this observational study, we collected the numbers of suicides in prison, rates of prison occupancy, and incarceration rates from primary sources in South America between 2000 and 2017. We compared suicide rates among prisoners with incidence rates in the general populations by calculating incidence rate ratios. We assessed the effect of gender, year, incarceration rates and occupancy on suicide rates in the prison populations using regression analyses. RESULTS: There were 1324 suicides reported during 4,437,591 person years of imprisonment between 2000 and 2017 in 10 South American countries. The mean suicide rate was 40 (95% CI 16-65) per 100,000 person years for male and female genders combined. The pooled incidence rate ratio of suicide between prison and general populations was 3.9 (95% CI 3.1-5.1) for both genders combined, 2.4 (95% CI 1.9-3.1) for men and a higher ratio in women (13.5, 95% CI 6.9-26.9). High occupancies of prisons were associated with lower incidence of suicide (β = - 58, 95% CI - 108.5 to - 7.1). CONCLUSIONS: Suicides during imprisonment in South America are an important public health problem. Suicide prevention strategies need to target prison populations.
Entities:
Keywords:
Incidence; Overcrowding; Prison; South America; Suicide