Can theory predict the process of suicide on entry to prison? Predicting dynamic risk factors for suicide ideation in a high-risk prison population

Background: Each year approximately 110,000 people are imprisoned in England and Wales and new prisoners remain one of the highest risk groups for suicide across the world. The reduction of suicide in prisoners remains difficult as assessments and interventions tend to rely on static risk factors with few theoretical or integrated models yet evaluated. Aims: To identify the dynamic factors that contribute to suicide ideation in this population based on Williams and Pollock's (2001) Cry of Pain (CoP) model. Method: New arrivals (N = 198) into prison were asked to complete measures derived from the CoP model plus clinical and prison-specific factors. It was hypothesized that the factors of the CoP model would be predictive of suicide ideation. Results: Support was provided for the defeat and entrapment aspects of the CoP model with previous self-harm, repeated times in prison, and suicide-permissive cognitions also key in predicting suicide ideation for prisoners on entry to prison. Conclusion: An integrated and dynamic model was developed that has utility in predicting suicide in early-stage prisoners. Implications for both theory and practice are discussed along with recommendations for future research.