Self-harm in the criminal justice system: a public health opportunity – 2018-01

Self-harm is a global public health problem associated with increased morbidity, suicide risk, and premature mortality. The behaviour is more prevalent in marginalised groups, including people in prison. The burden of self-harm and suicide in prison is considerable; a study from the UK estimated that the annual prevalence of self-harm in prisons was 5–6% in men and 20–24% in women. With the global imprisonment rate increasing annually, the extent to which the burden of self-harm is concentrated in prisons is also likely to be increasing.

Growing evidence has shown that the incidence of suicide both in prison and after release is markedly higher than in the general population. However, until recently there has been little research examining the epidemiology of self-harm after release from prison. Our study of 1325 adults released from prisons in Queensland, Australia, documented high rates of ambulance attendance and emergency department presentation for self-harm following release. Factors associated with these emergency health-care contacts included identifying as Indigenous, previous emergency health-care contact for self-harm, history of a mental disorder, and being identified by prison staff as being at risk of self-harm.

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Rohan Borschmann, Jesse T Young, Paul A Moran, Matthew J Spittal, Stuart A Kinner
The Lancet Public Health, January 2018