Epidemiological survey of suicide ideation and acts and other deliberate self-harm among offenders in the community under supervision of the Probation Service in England and Wales

Background There is a dearth of information on suicidal thoughts and acts or other acts of deliberate self-harm by offenders under community supervision.

Aims The objective of this study is to estimate lifetime and one month prevalence of deliberate self-harm and to determine ongoing risk among offenders in the community under probation supervision.

Methods One hundred and seventy-three randomly selected offenders under supervision by the probation service in one county in England were screened for mental illness. All 88 screened cases and a one-in-five sample of non-cases were interviewed according to the Mini International Neuropsychiatric Inventory Module-B. False negatives (n=17) were used to weight calculations and estimate prevalence for the whole group.

Results A third of the interviewed sample (n=56) had a lifetime history of suicide attempts, and 9 (5%) had self-harmed in the month prior to interview. Lifetime suicide history was associated with suicidal ideation and deliberate self-harm in the prior month.

Conclusions and implications Our adjusted findings indicate that 25-40% of offenders serving all or part of their sentence in the community have a lifetime history of self-harm, which is similar to the rate among prisoners, and are at very much higher risk of further such acts or completed suicide than the general population. At a time of change in delivery of probation services the implications are thatrates of suicide and other forms of deliberate self-harm should be continually assessed in all probation areas, particularly with reference to service changes;the relationship between deliberate acts of self-harm, suicidal ideation and completion of suicide should be investigated prospectively in larger studies;probation services are likely to need mental health expertise to manage these risks.