Correlates of suicide attempts in prison before and during the SARS-CoV-2 pandemic

• In Event: Prison Working Group: Mental health in prisons

Abstract

The SARS-CoV-2 pandemic has been associated with higher rates of suicide attempts in prisons. For example, the largest pre-trial prison in Switzerland reported a 57% increase in suicide attempts. To gain a better understanding of this alarming issue, this study aims to identify: (1) the reasons and motivations behind suicide attempts, (2) the factors associated with these events, and (3) to compare the results before and during the pandemic by collecting data from the prison and clinical records of 125 individuals (corresponding to 205 suicide attempts) who were detained in this institution.
Based on the emergency psychiatric reports, 14 different reasons for suicide attempts were identified. These reasons were categorized into mental and physical health issues (85%), prison-related problems (76%), and interpersonal relations (61%). Many suicide attempts were made as a protest or blackmail against the institution (39%). Other motivations included a desire to die (18%), alienation (11%), and seeking help (7%). Multivariable random-effect regressions revealed that different factors associated with suicide attempts included mental health problems, -consultations, history of self-harm, type of cell allocation (shared vs. single cell), prison visits, remand custody, age, and the method of suicide attempt (strangulation vs. abuse of medication). Although the characteristics of the prison population before and during the pandemic remained similar, there were significant increases in suicide attempts related to stress and anxiety (31%), dissatisfaction with medical treatment (104%), and physical pain (181%) during the pandemic.
These results suggest that the preventive measures implemented to tackle COVID-19 may have increased psychological distress among detained individuals, and the reduced availability of clinical resources during this period (which were focused on COVID-19 measures) may have exacerbated medical problems. Overall, these conditions may have had an impact on the mental and physical health of detained individuals, resulting in increased suicide attempts during the SARS-CoV-2 pandemic.

Authors

• Leonel Cunha Gonçalves, Geneva University Hospitals & University of Geneva

• Stéphanie Baggio, University of Bern