Suicidal Ideation Among Female Inmates: A Cross-Sectional Study

Abstract

Due to their complex mental health needs, female inmates comprise a particularly vulnerable group, at an elevated risk for suicide. Although suicidal ideation—the early stage in the trajectory towards suicidal behavior—represents a valid target for suicide prevention, there has been little research devoted to this outcome among female inmates. In order to address this void and to inform prevention efforts, the present study sought to investigate correlates of recent suicidal ideation among women incarcerated in Flanders, Belgium. A representative sample of prisoners (N = 123; aged 19–70 years) was randomly selected from all Flemish correctional facilities detaining female inmates, representing one in four incarcerated women throughout Belgium. Prevalence estimates for lifetime history of suicide ideation and attempts are 57.7% and 36.6%, respectively. Multivariate analysis indicates that women with recent suicidal ideation while incarcerated are significantly more likely than their non-suicidal peers to report a lifetime history of non-suicidal self-injury (aOR = 7.36), in-prison drug use (aOR = 4.72), and severe psychological distress (aOR = 3.14). The findings highlight the importance of providing adequate mental health services in prison, in order to address women’s unique needs and vulnerabilities, and consequently, to reduce suicide risk.

Keywords:

• Women
• prison
• mental health
• suicidal thoughts
• suicide prevention

Acknowledgments

Our sincere appreciation is extended to all participants and to the prison administrations in Flanders for their flexible cooperation in this study. Both authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Notes

1 In Belgium, offenders who are deemed criminally irresponsible (ODCI; also referred to as “internees” or “mentally ill offenders”) for their criminal actions because of mental illness or intellectual disability are subject to a specific safety measure with the dual objective of protecting society and providing mental health care to the offender. While Belgian law requires that ODCI should be in a hospital, clinic or other appropriate institution outside of prison, in practice, about one-third of all such offenders still reside in prison—a situation for which Belgium has repeatedly been criticized by the European Court of Human Rights. In 2016, 7.4% of the total prison population in Belgium were ODCI (N = 784), with slightly more than half of them residing in Flemish prisons (DG EPI, 2017). For this study, ODCI were a priori excluded since they constitute a specific population, and inclusion of this group may limit a reliable comparison to other international inmate samples, given this unique situation in Belgium (Vandevelde et al., 2011).

Additional information

Funding

This project was supported by the Special Research Fund (BOF) of Ghent University [BOF13/24J/145]. The funding agency did not have any involvement in the study design, data collection, data analysis, and the interpretation of results, nor in the writing or decision to submit the manuscript for publication.