attempts can help identify any patterns or past precipi-
tants that may be relevant to the current situation.
Specificity of the suicide plan needs to be deter-
mined. Generally, the more detailed (i.e., high speci-
ficity) a plan, the greater the risk of suicide.
Lethality of a suicide plan is defined as the amount
of time that passes between initiating the suicidal act
and dying. High lethality is a plan that results in a
quick death (e.g., hanging) and translates into high
risk. In addition to the lethality presented by a specific
method, there is also an impact resulting from how the
method will be used. Research on prison suicide has
revealed that hanging, a very lethal method, is the pri-
mary method of committing suicide.Self-Control
By examining a prisoner’s behavioral history (e.g.,
history of impulse control difficulties) and obtaining
information about previous suicide attempts, the pris-
oner’s degree of self-control can be assessed. Another
factor affecting self-control is the use of alcohol or
substances.Coping and Vulnerability
A prisoner’s poor ability to cope is a risk factor of
suicide. Research has identified a component of the
prison population that is particularly vulnerable and
poor copers. These individuals tend to have difficulty
coping across time and situations.
Psychosocial isolation (e.g., emotional and social
support) increases the likelihood of suicide. The pris-
oner’s access to emotional and social support
resources should be assessed.
Physical isolation of suicidal prisoners can have a
detrimental effect. Research addressing this issue had
revealed that placing suicidal prisoners in some form of
isolation (e.g., constant observation) is quite detrimental
and can actually contribute to increased suicidal risk.Suicide Prevention
Suicide prevention is typically conceptualized as an
institutional or organizational approach to preventing
prisoner suicides. Among the preventive strategies, there
can be policies and procedures that specify the manage-
ment of identified suicidal prisoners (e.g., type, fre-
quency, and/or location of observations; mental healthreferrals). More broadly, there can be policies, proce-
dures, and programs designed to improve identification
of suicidal prisoners. Screening for suicidal risk at intake
can be a valuable preventive strategy. During the last
decade, there has been an appreciable amount of
research directed toward developing effective screening
instruments. Some scales are designed to be adminis-
tered by nonclinical frontline staff at intake (e.g., correc-
tional staff), while other scales require mental health
training to administer. Some screening instruments have
been designed for specific settings (e.g., remand centers
vs. prisons), while other scales have been designed for
use across a variety of settings. Implementing a screen-
ing instrument can be influenced by human resource and
cost factors. A brief scale that requires no mental health
training to administer is typically less resource intensive
than a scale that may require clinically trained staff (e.g.,
nurse) to administer. However, the administrative costs
must be weighed against the effectiveness of the scale to
accurately identify prisoners as potential suicide risks.
An important component of suicide prevention pro-
grams includes training programs for prison staff.
These programs can vary in scope. Some training pro-
grams target improved knowledge about the indicators
of suicidality, while others target skill building in detec-
tion and basic intervention. Indeed, some institutions or
jurisdictions have developed programs that provide
training to prisoners in an effort to improve knowledge
and/or provide skills that facilitate detection and peer
support. Yet another suicide prevention strategy can
involve changes to the physical environment that essen-
tially decrease opportunity for a suicidal prisoner. For
example, changes in cell location (e.g., observation
cell) may improve visibility of a suicidal prisoner.
Improvements to the physical structure of a cell may
include installing tamper-proof fixtures and eliminating
structures that provide opportunities to implement a
suicide plan (e.g., a noose attached to a pipe).
Overall, research supports the conclusion that sui-
cide prevention programs can reduce the incidence of
prisoner suicides. Wider implementation of suicide
prevention policies, procedures, and programs is nec-
essary to further advance prevention efforts. Indeed,
more comprehensive suicide prevention programs
would also be beneficial.
Natalie H. PolviSee alsoCritical Incidents; Extreme Emotional Disturbance;
Forensic Assessment; Jail Screening Assessment Tool784 ———Suicide Assessment and Prevention in PrisonsS-Cutler (Encyc)-45463.qxd 11/18/2007 12:44 PM Page 784