Suicide in prison and after release: A 17-year national cohort study

Background

To describe all suicides in the Norwegian prison population from 2000 to 2017, during and following imprisonment; to investigate the timing of suicides; and to investigate the associations between risk of suicide and types of crime.

Methods.

We used data from the Norwegian Prison Release study (nPRIS) including complete national register data from the Norwegian Prison Register and the Norwegian Cause of Death Register in the period 1.1.2000 to 31.12.2016, consisting of 96 856 individuals. All suicides were classified according to ICD-10 codes X60-X84. We calculated crude mortality rates (CMRs) per 100 000 person-years and used a Cox Proportional-Hazards regression model to investigate factors associated with suicide during imprisonment and after release reported as hazard ratios (HRs).

Results

Suicide accounted for about 10% of all deaths in the Norwegian prison population and was the leading cause of death in prison (53% of in deaths in prison). The CMR per 100 000 person years for in-prison suicides was 133.8 and was ten times higher (CMR = 1535.0) on day one of incarceration. Suicides after release (overall CMR = 82.8) also peaked on day one after release (CMR = 665.7). Suicide in prison and after release were both associated with being convicted of murder (HR: 27.41, CI: 3.42-219.63 and HR: 2.79, CI: 1.54–5.06, respectively).

Conclusion

There is a high risk of suicide during the immediate first period of incarceration and after release. Convictions for severe violent crime, especially murder, are associated with increased suicide risk, both in prison and after release.