Wednesday, November 12, 2014

Suicide among released prisoners, report from Sweden

Today, I read an academic article regarding suicide in the Journal of Clinical Psychiatry.

Journal of Clinical Psychiatry is one of the most popular journals in psychiatry. It is not an open-access journal, but this article is disclosed in public for free, so I could read it at home. It describes the rate of suicide among released prisoners in Sweden.

Journal of Clinical Psychiatry: Suicide After Release From Prison: A Population-Based Cohort Study From Sweden

According to the authors, the risk of suicide in released prisoners was higher than in the general population by 20 times. Substance misuse and suicide attempts in the past are identified as risk factors.

These results are not surprising. Past behaviors are the most strong predictors of the future. In both violence and suicidal act, people who have an experience once are perpetually risky. Interestingly, substance misuse seems to have a role as a modifier to suicidal risk in prisoners and others.

Yet we should be cautious about such high ratio of suicidal risk. It is easy to imagine that released prisoners have several problems such as low education, poverty, low self-esteem, difficulty to adhere the rules, and several mental disorders. Nonetheless, they were released based on the expectation to be reintegrated into society. Suicide is deemed as an absolute failure. We need to do something against this result.

It is a little strange that people born in Sweden were more likely to commit suicide after the release from prison. The authors referred to the suicide statistics in immigrants, but reserved the conclusion. The characteristics of foreign people who committed a crime are hardly to be analyzed due to small sample size. Perhaps, this result is merely a noise.

By the way, this study followed almost 40,000 persons in 4 years. The number of participants is serious. The fact that personal identification number is adopted in Sweden made it possible to conduct such a big study, needless to say about the great efforts of the researchers. Instead, to conduct a survey in prisoners itself is quite difficult in Japan. Considering the cultural background of suicide, we should not simply adapt these results to Japanese. I would like to perform such a big survey in Japan.

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