Preventing self-harm and suicide in prisoners: job half done

What we do know is that prisoners have high levels of mental health morbidity.2 Suicide is the prevailing cause of death in prison worldwide, with mortality rates more than three times higher than the general population.3 The risk of death is highest in the early period after prison reception.4 In male prisoners, deaths occur most typically in local adult prisons that take people directly from the courts, whereas self-harm happens widely in female prisons.5 Mental disorder, substance misuse, white ethnic origin, violent offending, awaiting trial, and having suicidal ideas are risk factors for death, many of which are common globally.6 Although most risk factors for suicide are also prevalent in the general population, their frequency in prison is alarming.2 Writing in The Lancet, Keith Hawton and colleagues7 provide important confirmation of risk factors for self-harm and suicide in prison.