Journal article 173 views
Self-harm before and during imprisonment: a cohort study of Welsh males in prison linking population-based routinely collected data
Marcos del Pozo Banos 
,
Mark Atkinson ,
Sze Chim Lee ,
Ann John
,
Mark Atkinson ,
Sze Chim Lee ,
Ann John
BJPsych Open
Swansea University Authors:
Marcos del Pozo Banos , Mark Atkinson , Sze Chim Lee , Ann John
Full text not available from this repository: check for access using links below.
DOI (Published version): 10.1192/bjo.2025.10898
Abstract
Background: Self-harm among UK prisoners has risen over the past decade. Aims: To explore self-harm risk factors and mental health conditions in prisoners, pre- and during-imprisonment, compared to the general population. Method: This retrospective cohort study linked electronic health records and M...
| Published in: | BJPsych Open |
|---|---|
| ISSN: | 2056-4724 |
| Published: |
Cambridge University Press (CUP)
|
| Online Access: |
Check full text
|
| URI: | https://cronfa.swan.ac.uk/Record/cronfa70702 |
| Abstract: |
Background: Self-harm among UK prisoners has risen over the past decade. Aims: To explore self-harm risk factors and mental health conditions in prisoners, pre- and during-imprisonment, compared to the general population. Method: This retrospective cohort study linked electronic health records and Ministry of Justice data for Welsh males prisoners (2019), and a comparison general population cohort. We examined imprisonment likelihood based on prior self-harm and mental health conditions using logistic regression, and self-harm risk up to three years during-imprisonment through Generalised Estimating Equations and time-stratified Cox regression, using a pre-imprisonment comparator (three years before). Results: Prisoners (N=6,095) had higher rates of self-harm and mental health conditions pre-imprisonment compared to non-prisoners (e.g., self-harm odds ratio: 2.1 [1.9, 2.2]). Self-harm risk was 5.25-6.47 times higher in prisoners than non-prisoners, both pre- and during-imprisonment. Risk was highest shortly after incarceration, then declined, becoming lower than pre-imprisonment after 7 months. While most conditions correlated with higher self-harm risk during imprisonment (e.g., drug use, hazard ratios: 1.5-3.0), some (e.g., depression and alcohol use) showed weaker links in prisoners than non-prisoners, particularly from 7 months after imprisonment. Self-harm risk was seemingly higher in prisoners on remand compared to sentenced. Conclusions: Pre-imprisonment, self-harm in male prisoners is already high compared to the general population, potentially driving a saturation effect, where known general population risk factors have a weaker effect in prisoners. Self-harm prevention should target people in contact with criminal justice, irrespective imprisonment. In prisons, prevention efforts deployed at inception should target those with prior self-harm, drug use, learning difficulties and bipolar disorder, and those on remand. |
|---|---|
| Item Description: |
In press |
| College: |
Faculty of Medicine, Health and Life Sciences |
| Funders: |
Administrative Data Research (ADR) Wales programme of work, Medical Research Council and Health Data Research UK (Grant DATAMIND: Data Hub for Mental Health INformatics research Development, with Ref.: MR/W014386/1), Health and Care Research Wales (Grant NCSSHP: National Centre for Suicide and Self-harm Prevention) |