The identification and management of suicide risk in local prisons

This study aimed to examine rates of mental illness and suicidal ideation in a random sample of prisoners in four UK prisons, and to examine the characteristics and quality of care received by prisoners identified as at current risk of suicide/self harm. Methods used were: cross-sectional study of mental illness and suicidal ideation in a random sample of prisoners, and in all prisoners specifically managed as a suicide risk; examination of suicide risk care plans; and comparative study of information sharing across suicide risk and healthcare documentation. Results showed that prisoners identified as at risk of suicide/self harm had significantly higher rates of clinically significant symptoms of mental illness, as measured by a standardized instrument, than the general prison population. There was a high level of suicide risk that had not been identified. Problems with the delivery of planned care interventions were revealed and little congruence was found between systems of documentation. The suicide care planning system was correctly targeting a proportion of those at risk but high levels of unmet need remained. The care planning and information sharing processes within prisons and between prisons and other agencies should be improved.