Center on Sentencing and Corrections

Risk factors for self-harm in prison: a systematic review and meta-analysis

Risk factors for self-harm in prison: a systematic review and meta-analysis

Favril, Louis, Rongqin Yu, Keith Hawton, and Seena Fazel. “Risk factors for self-harm in prison: a systematic review and meta-analysis.” The Lancet Psychiatry 7, no. 8 (2020), 682-691.

This article, published in The Lancet Psychiatry, provides a systematic review and meta-analysis of 35 independent studies from 20 countries that examined risk factors for self-harm in the incarcerated population. Studies included in the analysis focused primarily on incarcerated adults in the general prison population and provided data for control or comparison groups of incarcerated people who did not self-harm in prison. Of the 662,735 incarcerated included in the analyzed studies, nearly 4 percent had self-harmed in prison.

Researchers examined 40 risk factors for self-harm in prison, including:

  • sociodemographic risk factors (e.g., homelessness, unemployment before incarceration, and age)
  • criminological risk factors (e.g., violent offenses, previous incarceration, a sentence of 5 years or more, and life sentence)
  • clinical risk factors (e.g., suicidal ideation, psychiatric treatment, and psychiatric diagnosis)
  • historical risk factors (e.g., childhood abuse, family history of suicide, and any history of sexual abuse)
  • custody-specific risk factors (e.g., solitary confinement, violence or assault perpetration, and disciplinary infractions).

The authors found that segregation was the leading custodial risk factor for self-harm in prison. The authors note that the association could be due to reverse causality, such as when segregation is a consequence of self-harm and suggests future research is needed to explore whether placement in segregation can predict self-harm during imprisonment.

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Keywords: self-injurious behavior, mental health, self-mutilation, suicide attempt, and overdose.