Suicide-related behaviour is a complex and multi-causal phenomenon, with elevated prevalence in penitentiary institutions. When compared with general population, incarcerated individuals present an increased risk of attempting suicide and engaging in self-injurious behaviour. A wide variety of specific psychological interventions have been developed aiming prevention, which still need to show effective results. Therefore, we reviewed empirical research on the efficiency of programs aimed to prevent suicidal and self-injurious behaviour in prisons, to better understand suicide prevention in incarcerated individuals.
We searched EBSCOHost, ScienceDirect, PubMed & ProQuest databases to identify relevant articles from 1990 to 2022, based on the review developed by Winicov (2019) that covered the time lapse between 1990 and 2015. Inclusion criteria were empirical studies evaluating prevention programs for suicidal and self-injurious behaviour in penitentiary context. Our review was conducted following the directives of the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA).
18 of the 44,050 potential studies were included (9 studies included in the review by Natalie Winicov, 2019 were also included herein). Most studies were conducted in United Kingdom (n=8), with the most common design being pre-post studies without a control group (k = 9) and the sample size for each study varied considerably. Most of the studies included men or did not specify gender (three of the studies included only incarcerated women). Substantial variation was found in the definition of suicide related concepts and in the type of treatment. Findings for 14 studies showed efficacy of intervention programs on self-injury behavior. On average the use of Cognitive Behavioural Therapy (CBT) reduced suicidal ideation, and positive results were observed in 3 studies using third-generation therapies as an intervention.
Suicidal and self-injurious behavior in prison shows lower levels of incidence when specific psychological prevention programs are applied. It’s crucial for future studies to increase the evaluation in relation to the implementation of new treatment models (i.e., Dialectical Behavior Therapy - DBT, Acceptance and Commitment Therapy - ACT, Mindfulness, Functional Analytic Psychotherapy – FAP) as to better orientate prevention strategies. Further research is needed in gender sensitive interventions.