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Suicide in prison- Issues
- Ravi Shankar Balu, G. Derek (psychologist) (19 April 2004)
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Ravi Shankar Balu, Medical officer Kestrel,Medium Secure Unit,Morisset, NSW-2264, Australia.Fax No: (02) 4973 0334.Ph-02-49509945, G. Derek (psychologist)
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drravishankar{at}hotmail.com Ravi Shankar Balu, et al.
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We read with interest, Shaw et al’s(2004) Suicide by Prisoners and would like to discuss a few issues.Whilst we acknowledge the value of statistical summaries such as the national clinical survey it should be noted that there are difficulties in applying methods to study the risk in the community to prison populations, particularly when this information may be is transferred to clinical use. Few guidelines exist and formal assessments for good professional practice exist for such work and we recommend additional factors for future research. Firstly we would like to comment that the prison by itself is a risk factor; however the clinical survey does not reflect the contextual factors leading to suicide. The suicide behavior is usually transient and a reaction in a particular individual to their set circumstances. In addition to the trait, clinical and personal factors, offenders face other dynamic factors like, life events, the stress of arrest, trial, and variety of stressors associated with prison life like bullying, intimidation, isolation, that are amenable to change and can be targeted as areas of possible intervention. Secondly recommendations you have made for the management of suicide in prisons are the same for every inmate and situation. The treatment has to be different from situation to situation, and be shaped by the particular circumstances of the inmate. However the treatments like social isolation, segregation and strip cells for the prisoner have been found to be associated with self-harm and thus we are forced to look at alternative methods of treatment. Finally, though only small proportion of prisoner’s self- harm, clinicians often face the difficulty of determining varying levels of risk and subsequent management that is often limited to and by the physical resources of the prison environment. The focus of research should be to identify factors actuarially explaining the individual differences amongst prisoners and it would be valuable to identify the characteristics of the prisoners who self- harm compared to those who do not. We propose the answer to this question lies in a combination of internal vulnerability factors and external stressors. Shaw, J., Baker, D., Hunt, I.M., Moloney, A., Appleby, L. (2004) Suicide by prisoners. National clinical survey. British Journal of Psychiatry, 184.263-267. Decleration of Intrest: None |
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