A typology of male prisoners making near-lethal suicide attempts
Rivlin, A., Ferris, R., Marzano, L., Fazel, S., & Hawton, K.
Background: Prisoners are at high risk of suicide. Aims: This study aimed to develop a typology of prison suicide. Method: We interviewed 60 male prisoners who made near-lethal suicide attempts in prison to obtain quantitative and qualitative data regarding psychiatric, psychological, social, and criminological factors. We analyzed this information to develop a typology to classify suicidal prisoners and validated it by having a prison psychiatrist independently rate each interview transcript. Results: We developed a typology of five subgroups: attempts that (1) were due to a prisoner being unable to cope in prison, (2) were motivated by psychotic symptoms, (3) had instrumental motives, (4) were "unexpected" by the prisoners themselves, and (5) were associated with withdrawal from drugs. The interrater reliability as measured by Cohen's was good to excellent at 0.81 (p < .001), 95% CI (0.69, 0.93). Conclusion: With further validation in other samples, this typology may assist suicide prevention initiatives in prisons as well as other forensic institutions by informing the assessment and formulation of suicide risk.