Suicide behavior of detained in custody

The article reviews literature on suicidal behavior of individuals detained in custody. It is stated that death by suicide among this category exceeds average rages for general population 2-3 times. The exact number of suicide attempts is not known because on one hand it is hard to verify some forms of suicide, and on the other self harming behavior is rather prevalent under isolation even though it does not contain suicide intention - 19 to 37%. For differentiation diagnostics it is important to be able to observe suicide ideation (reported by 40% male and 53,7% female prisoners), suicide motivation and suicide history. General groups and factors of suicide risk include: young males, aggressiveness, first conviction, psychosocial desadaptation before custody, heavy social deprivation, substance abuse and addiction, forcing homosexual relationships, mockery (up to 34% of suicide attempters). The highest suicide risk is registered among prisoners of remand centers: up to 32-38% suicide cases of all cases registered in Federal Penitentiary Service with 17% share of suicide cases registered among people under confinement. Up to 38% of completed suicides happen during first month in detention unit, around 25% right after sentencing or its coming into force, significant share (30 to 55%) of suicide take place when prisoner is held in a single chamber. Most prevalent means of suicide is hanging (83%), most prevalent means of self harm is - self cutting (60%). Important prosuicide factors include alcohol consumption and substance addiction, psychiatric and personality disorders, HIV, tuberculosis and so on. Prevention measures require complex and multilevel approach at all stages of temporary and long-term detention, wider involvement of mental health specialists, improvement of detention conditions, accessibility of medical care, training of non-medical (departmental) staff.