An examination of former prisoners’ mental health problems before death by suicide over a 21-year period (2001–2021)

Background Former prisoners are a vulnerable population, and suicide rates among this group are high, particularly following release from prison. Aims To explore former prisoners’ engagement with mental health services before death by suicide, and to examine the demographics, clinical history an...

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Main Authors: Alison Baird, Lana Bojanić, Saied Ibrahim, Jessica Kenworthy, Pauline Turnbull, Navneet Kapur, Louis Appleby, Jenny Shaw, Daniel Pratt
Format: Article
Language:English
Published: Cambridge University Press 2025-07-01
Series:BJPsych Open
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Online Access:https://www.cambridge.org/core/product/identifier/S2056472425000717/type/journal_article
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author Alison Baird
Lana Bojanić
Saied Ibrahim
Jessica Kenworthy
Pauline Turnbull
Navneet Kapur
Louis Appleby
Jenny Shaw
Daniel Pratt
author_facet Alison Baird
Lana Bojanić
Saied Ibrahim
Jessica Kenworthy
Pauline Turnbull
Navneet Kapur
Louis Appleby
Jenny Shaw
Daniel Pratt
author_sort Alison Baird
collection DOAJ
description Background Former prisoners are a vulnerable population, and suicide rates among this group are high, particularly following release from prison. Aims To explore former prisoners’ engagement with mental health services before death by suicide, and to examine the demographics, clinical history and clinical care of this patient group and compare them with patients who died by suicide who had not been to prison. Method The clinical, sociodemographic and care characteristics of patients in contact with mental health services who died by suicide in the UK were examined in a national clinical survey between 1 January 2001 and 31 December 2021, and comparisons were made between former prisoners and patients with no history of being in prison. Results Of the 33 381 (median age 46 years, range 10–100; 65.6% male) patients who died by suicide in the UK and had been in contact with mental health services in the 12 months before death, 3335 (11%) were ex-prisoners (male n = 2988, 90%; female n = 347, 10%). Compared with other patients, ex-prisoner patients had higher frequencies of personality disorder, schizophrenia and delusional disorders, as well as childhood abuse. Ex-prisoner patients were more likely to be male, to be aged between 45 and 65 years (median age 39, range 17–89), to live in deprived areas and to have a history of substance misuse. We found no differences in ethnicity. Conclusions Mental health services need to focus particularly on patients with a history of being in prison who are experiencing economic adversity and offer substance-use-related interventions to ensure continued patient engagement. The link with deprivation is striking at a time at which rising costs of living are resulting in more health inequalities.
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spelling doaj-art-321dcd307a9c4d5ea7f0b89c92dec27b2025-08-20T03:23:10ZengCambridge University PressBJPsych Open2056-47242025-07-011110.1192/bjo.2025.71An examination of former prisoners’ mental health problems before death by suicide over a 21-year period (2001–2021)Alison Baird0https://orcid.org/0000-0003-3711-9382Lana Bojanić1https://orcid.org/0000-0003-2067-2966Saied Ibrahim2Jessica Kenworthy3Pauline Turnbull4Navneet Kapur5https://orcid.org/0000-0002-3100-3234Louis Appleby6Jenny Shaw7Daniel Pratt8https://orcid.org/0000-0001-8843-1224National Confidential Inquiry into Suicide and Safety in Mental Health, Centre for Mental Health and Safety, Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UKNational Confidential Inquiry into Suicide and Safety in Mental Health, Centre for Mental Health and Safety, Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UKNational Confidential Inquiry into Suicide and Safety in Mental Health, Centre for Mental Health and Safety, Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UKSchool of Health, Science and Wellbeing, University of Staffordshire, Stoke-on-Trent Campus, UKNational Confidential Inquiry into Suicide and Safety in Mental Health, Centre for Mental Health and Safety, Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UKNational Confidential Inquiry into Suicide and Safety in Mental Health, Centre for Mental Health and Safety, Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UKNational Confidential Inquiry into Suicide and Safety in Mental Health, Centre for Mental Health and Safety, Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UKDivision of Psychology and Mental Health, University of Manchester, Manchester, UKDivision of Psychology and Mental Health, University of Manchester, Manchester, UK Manchester Academic Health Science Centre, Manchester, UK Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK Background Former prisoners are a vulnerable population, and suicide rates among this group are high, particularly following release from prison. Aims To explore former prisoners’ engagement with mental health services before death by suicide, and to examine the demographics, clinical history and clinical care of this patient group and compare them with patients who died by suicide who had not been to prison. Method The clinical, sociodemographic and care characteristics of patients in contact with mental health services who died by suicide in the UK were examined in a national clinical survey between 1 January 2001 and 31 December 2021, and comparisons were made between former prisoners and patients with no history of being in prison. Results Of the 33 381 (median age 46 years, range 10–100; 65.6% male) patients who died by suicide in the UK and had been in contact with mental health services in the 12 months before death, 3335 (11%) were ex-prisoners (male n = 2988, 90%; female n = 347, 10%). Compared with other patients, ex-prisoner patients had higher frequencies of personality disorder, schizophrenia and delusional disorders, as well as childhood abuse. Ex-prisoner patients were more likely to be male, to be aged between 45 and 65 years (median age 39, range 17–89), to live in deprived areas and to have a history of substance misuse. We found no differences in ethnicity. Conclusions Mental health services need to focus particularly on patients with a history of being in prison who are experiencing economic adversity and offer substance-use-related interventions to ensure continued patient engagement. The link with deprivation is striking at a time at which rising costs of living are resulting in more health inequalities. https://www.cambridge.org/core/product/identifier/S2056472425000717/type/journal_articleSuicideprisonex-prisonermental health patientschildhood abuse
spellingShingle Alison Baird
Lana Bojanić
Saied Ibrahim
Jessica Kenworthy
Pauline Turnbull
Navneet Kapur
Louis Appleby
Jenny Shaw
Daniel Pratt
An examination of former prisoners’ mental health problems before death by suicide over a 21-year period (2001–2021)
BJPsych Open
Suicide
prison
ex-prisoner
mental health patients
childhood abuse
title An examination of former prisoners’ mental health problems before death by suicide over a 21-year period (2001–2021)
title_full An examination of former prisoners’ mental health problems before death by suicide over a 21-year period (2001–2021)
title_fullStr An examination of former prisoners’ mental health problems before death by suicide over a 21-year period (2001–2021)
title_full_unstemmed An examination of former prisoners’ mental health problems before death by suicide over a 21-year period (2001–2021)
title_short An examination of former prisoners’ mental health problems before death by suicide over a 21-year period (2001–2021)
title_sort examination of former prisoners mental health problems before death by suicide over a 21 year period 2001 2021
topic Suicide
prison
ex-prisoner
mental health patients
childhood abuse
url https://www.cambridge.org/core/product/identifier/S2056472425000717/type/journal_article
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