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      Suicidios en prisión: algunas tareas pendientes Translated title: Suicides in prison: some pending tasks

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          Abstract

          Resumen: En la actualidad el suicidio es un auténtico problema de salud pública a nivel mundial y la primera causa de muerte no natural en España. Sin pretender una investigación exhaustiva sobre el tema, que excedería los límites de este artículo, se realiza una revisión general del concepto y un breve análisis crítico del modo en el que se recopilan los datos: se trata de un fenómeno infravalorado y es necesario mejorar la fiabilidad de las cifras manejadas. Tras recopilar la información oficial sobre el suicidio en la población penitenciaria española, con una tasa significativamente superior a la de la población general, se recogen los factores de riesgo y de protección a tener en cuenta para mejorar las políticas preventivas. Se cierra la exposición con un inventario de buenas prácticas que la Institución Penitenciaria no solo debe incorporar al Programa Marco de Prevención de Suicidios, sino también velar por su cumplimiento efectivo; para ello es imprescindible la detección precoz y la coordinación de los profesionales penitenciarios con la Red Sanitaria Pública.

          Translated abstract

          Abstract: At present, suicide is a real public health problem worldwide and the leading cause of unnatural death in Spain. With no intention of carrying out an exhaustive investigation on the subject, which would exceed the limits of this article, a general review of the concept and a brief critical analysis of the way in which data are collected are carried out. Suicide is an undervalued phenomenon and it will be necessary to improve the reliability of the statistical figures handled. After compiling official information on suicide in the Spanish prison population, with a rate considerably higher than in the general population, the risk and protection factors to be taken into account to improve preventive policies are collected. The exposition closes with an inventory of good practices that the Penitentiary Institution must not only incorporate into the Framework Program for Suicide Prevention, but also ensure its effective compliance. An early detection and the coordination of professionals with the Public Health Network is needed for this proper compliance.

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          Effectiveness of brief intervention and contact for suicide attempters: a randomized controlled trial in five countries

          Alexandra Fleischmann, José Bertolote, Danuta Wasserman … (2008)
          OBJECTIVE: To determine whether brief intervention and contact is effective in reducing subsequent suicide mortality among suicide attempters in low and middle-income countries. METHODS: Suicide attempters (n = 1867) identified by medical staff in the emergency units of eight collaborating hospitals in five culturally different sites (Campinas, Brazil; Chennai, India; Colombo, Sri Lanka; Karaj, Islamic Republic of Iran; and Yuncheng, China) participated, from January 2002 to October 2005, in a randomized controlled trial to receive either treatment as usual, or treatment as usual plus brief intervention and contact (BIC), which included patient education and follow-up. Overall, 91% completed the study. The primary study outcome measurement was death from suicide at 18-month follow-up. FINDINGS: Significantly fewer deaths from suicide occurred in the BIC than in the treatment-as-usual group (0.2% versus 2.2%, respectively; χ2 = 13.83, P < 0.001). CONCLUSION: This low-cost brief intervention may be an important part of suicide prevention programmes for underresourced low- and middle-income countries.
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            Suicide in prisons: an international study of prevalence and contributory factors

            Seena Fazel, Taanvi Ramesh, Keith Hawton (2017)
            Summary Background Prison suicide rates, rate ratios, and associations with prison-related factors need clarification and updating. We examined prison suicide rates in countries where reliable information was available, associations with a range of prison-service and health-service related factors, how these rates compared with the general population, and changes over the past decade. Methods We collected data for prison suicides in 24 high-income countries in Europe, Australasia, and North America from their prison administrations for 2011–14 to calculate suicide rates and rate ratios compared with the general population. We used meta-regression to test associations with general population suicide rates, incarceration rates, and prison-related factors (overcrowding, ratio of prisoners to prison officers or health-care staff or education staff, daily spend, turnover, and imprisonment duration). We also examined temporal trends. Findings 3906 prison suicides occurred during 2011–14 in the 24 high-income countries we studied. Where there was breakdown by sex (n=2810), 2607 (93%) were in men and 203 (7%) were in women. Nordic countries had the highest prison suicide rates of more than 100 suicides per 100 000 prisoners apart from Denmark (where it was 91 per 100 000), followed by western Europe where prison suicide rates in France and Belgium were more than 100 per 100 000 prisoners. Australasian and North American countries had rates ranging from 23 to 67 suicides per 100 000 prisoners. Rate ratios, or rates compared with those in the general population of the same sex and similar age, were typically higher than 3 in men and 9 in women. Higher incarceration rates were associated with lower prison suicide rates (b = –0·504, p = 0·014), which was attenuated when adjusting for prison-level variables. There were no associations between rates of prison suicide and general population suicide, any other tested prison-related factors, or differing criteria for defining suicide deaths. Changes in prison suicide rates over the past decade vary widely between countries. Interpretation Many countries in northern and western Europe have prison suicide rates of more than 100 per 100 000 prisoners per year. Individual-level information about prisoner health is required to understand the substantial variations reported and changes over time. Funding Wellcome Trust and the UK National Institute for Health Research (NIHR).
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              Suicide in prisoners: a systematic review of risk factors.

              Keith Hawton, Julia Cartwright, Edward Cartwright … (2008)
              To examine factors associated with suicide in prisoners. Studies were identified through electronic searches of MEDLINE (1950-February 2007), PsycINFO (1806-February 2007), EMBASE (1974-February 2007), and CINAHL (1982-February 2007) without language restriction using the search terms prison, jail, felon, detainee, penal, and custody combined with suicide. Included studies were investigations that reported on prisoners dying by suicide who were compared with prisoners in control groups (which were randomly selected or matched, or consisted of the total or average prison population). Subgroup analysis and meta-regression were used to explore sources of heterogeneity. Thirty-four studies (comprising 4780 cases of prison suicide) were identified for inclusion in the review, of which 12 were based in the United States. Demographic factors associated with suicide included white race/ethnicity (OR = 1.9, 95% CI = 1.7 to 2.2), being male (OR = 1.9, 95% CI = 1.4 to 2.5), and being married (OR = 1.5, 95% CI = 1.3 to 1.7). Criminological factors included occupation of a single cell (OR = 9.1, 95% CI = 6.1 to 13.5), detainee/remand status (OR = 4.1, 95% CI = 3.5 to 4.8), and serving a life sentence (OR = 3.9, 95% CI = 1.1 to 13.3). Clinical factors were recent suicidal ideation (OR = 15.2, 95% CI = 8.5 to 27.2), history of attempted suicide (OR = 8.4, 95% CI =6.2 to 11.4), having a current psychiatric diagnosis (OR = 5.9, 95% CI = 2.3 to 15.4), receiving psychotropic medication (OR = 4.2, 95% CI = 2.9 to 6.0), and having a history of alcohol use problems (OR = 3.0, 95% CI = 1.9 to 4.6). Black race/ethnicity was inversely associated with suicide (OR = 0.4, 95% CI = 0.3 to 0.4). Few differences were found in risk estimates when compared by study design or publication type. Several demographic, criminological, and clinical factors were found to be associated with suicide in prisoners, the most important being occupation of a single cell, recent suicidal ideation, a history of attempted suicide, and having a psychiatric diagnosis or history of alcohol use problems. As some of these associations included potentially modifiable environmental and clinical factors, there is scope for targeting these factors in suicide prevention strategies for individuals in custody. Copyright 2008 Physicians Postgraduate Press, Inc.
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                Author and article information

                Journal
                Journal ID (publisher-id): neuropsiq
                Title: Revista de la Asociación Española de Neuropsiquiatría
                Abbreviated Title: Rev. Asoc. Esp. Neuropsiq.
                Publisher: Asociación Española de Neuropsiquiatría (Madrid, Madrid, Spain )
                ISSN (Print): 0211-5735
                ISSN (Electronic): 2340-2733
                Publication date (Print and electronic): June 2022
                Volume: 42
                Issue: 141
                Pages: 187-205
                Affiliations
                [1] Bilbao orgnameEkimen elkartea España
                [2] Valdemoro Madrid orgnameCentro Penitenciario Madrid III España
                [3] Tarragona orgnameC.P. Mas d'Enric España
                Article
                Publisher ID: S0211-57352022000100187 Publisher ID: S0211-5735(22)04214100187
                DOI: 10.4321/s0211-57352022000100012
                SO-VID: d2942fb3-2538-475b-87c4-d40f78596a27
                License:

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 International License.

                History
                Date accepted : 30 April 2022
                Date received : 09 March 2022
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 68, Pages: 19
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                SciELO Spain

                Categories
                Subject: Dossier: Atención a la salud mental en prisión

                Keywords: suicidio,prevention,risk factors,prison,data logging,suicide,prevención,factores de riesgo,centro penitenciario,registro de datos
                Data availability:
                Keywords: suicidio, prevention, risk factors, prison, data logging, suicide, prevención, factores de riesgo, centro penitenciario, registro de datos

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