Academic journal article Population

Trends and Risk Factors for Prisoner Suicide in France

Academic journal article Population

Trends and Risk Factors for Prisoner Suicide in France

Article excerpt

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Nearly half of all deaths in French prisons are suicides, and the associated mortality level is far higher than for the general population (Duthé et al., 2009; Aebi and Delgrande, 2010). This particular aspect of prison life and the heightened vulnerability of inmates to suicide were first brought to light many years ago, both in France (Chesnais, 1976; Tournier and Chemithe, 1979; Kensey, 1991; Bourgoin, 1993a) and in many other countries (Kariminia et al., 2007; Fazel et al., 2010). There has been a substantial overall rise in the prisoner suicide rate over recent decades, and in the mid-2000s it was higher in France than in any other Western European country(1) (Aubusson de Cavarlay, 2009; Duthé et al., 2009).

The factors linked to suicide in prison are quite different from those applicable to the general population, owing to the very particular conditions in which these deaths occur. Several studies have shown that the risk is especially high at the time of incarceration, and that pre-trial detainees commit suicide more than sentenced prisoners.(2) Persons convicted for violent or sexual offences are overrepresented among suicide victims, as are those serving lengthy sentences. Regarding conditions of detention, suicide is more frequent among inmates who are alone in their cells or placed in solitary confinement as a disciplinary measure. Among sociodemographic factors, there is no consensus on the effect of age. Furthermore, even though excess suicide among female prisoners with respect to women in the general population is far greater than that of men (Bourgoin, 1993a), prison suicides are still more frequent among men than women. In prison, suicide is less frequent among single inmates than among married ones, whereas the reverse is true in the general community (Durkheim, 1897). This is because prisoners with partners have to cope with the additional burden of separation and loss of contact.(3) In countries where the relevant data are available, ethnic origin has also been found to have an effect, with the majority group having a higher risk. Last, mental and behavioural problems, more frequent among prisoners than in the general population (Fazel and Danesh, 2002; Mouquet, 2005; Falissard et al., 2006), are also strongly associated with suicide risk.(4)

Limited access to individual prisoner data, plus the fact that suicide is statistically infrequent, makes it difficult to conduct statistical studies. Most research has been based on aggregate comparisons matching the characteristics of inmates who have committed suicide against those of the general prison population, or has involved long observation periods, or comparisons with control groups. There have been very few exhaustive multivariate statistical studies at the individual level to assess the effects of each separate risk factor. To gain a clearer picture of prison suicide in France, we analysed data drawn from the national prisoner management system (GIDE) operated by the French prison service (Direction de l'administration pénitentiaire, DAP). These data concerned nearly 378,000 periods of detention between 1 January 2006 and 15 July 2009, during which time 378 suicides were recorded. Because we knew the precise dates on which events occurred during the observation period, we were able to explore differential risks by taking the period of risk exposure into account. We could also consider possible changes in prisoners' penal status or conditions of detention.

How has prison suicide evolved over time in France? What factors increase suicide risk? In this article, we begin by looking at how prisoner suicides have changed since observations began in the mid-nineteenth century, flagging up differences with respect to suicide in the general population. In the second section, we focus on a more recent period, looking for associations between the characteristics of individual detainees and suicide risk. …

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