Accuracy and predictive value of incarcerated adults' accounts of their self-harm histories: findings froman Australian prospective data linkage study

Borschmann, Rohan; Young, Jesse T; Moran, Paul; Spittal, Matthew J; Snow, Kathryn; Mok, Katherine; Kinner, Stuart A

doi:10.9778/cmajo.20170058

Cited by 29 publications

(27 citation statements)

References 57 publications

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“…Differing levels of support from non-government organisations (NGOs) and service providers on Nauru and Manus Island, as well as the timing of the roll-out and use of the new centralised data base for recording incidents (known as the Planning and Operational Management System (POMS)) during this period, may have also contributed to inconsistent reporting and recording of incidents for these populations (ANAO, 2017). Furthermore, recent research has highlighted the methodological limitations of using only one data source to identify self-harm, including among incarcerated adults (Borschmann et al, 2011, 2017). The self-harm figures for the Australian asylum seeker population recorded here, based on the incidents reported to the DIBP in the 12 months to 31st July 2015, are likely to reflect an under-ascertainment of the true number of incidents.…”

Section: Discussionmentioning

confidence: 99%

Self-harm in the Australian asylum seeker population: A national records-based study

Hedrick

Armstrong

Coffey

et al. 2019

SSM - Population Health

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Background Systematic research into self-harm in the Australian asylum seeker population is scarce, largely due to the lack of accessible data. The aim of this study was to examine the incidence and characteristics of self-harm across the Australian asylum seeker population, and to ascertain whether self-harm rates and characteristics vary by processing arrangements (i.e. community-based arrangements, community detention, onshore detention, offshore detention (Nauru), and offshore detention (Manus Island)), and gender. Methods Data relating to the incidence of self-harm, method(s) used to self-harm, processing arrangements, and gender were extracted from all self-harm incidents recorded as occurring among the Australian asylum seeker population between 1st August 2014 and 31st July 2015. Self-harm episode rates were calculated using the average estimated adult population figures for the 12-month period for each asylum seeker population. Results 949 self-harm episodes were included in the analyses. Rates ranged from 5 per 1000 asylum seekers in community-based arrangements to 260 per 1000 asylum seekers in offshore detention in Nauru. Rates were highest among asylum seekers in offshore and onshore detention facilities, and lowest among asylum seekers in community-based arrangements and community detention. The most common methods of self-harm were cutting (37%), self-battery (26%), and attempted hanging (11%), with asylum seekers in held detention using a wider variety of methods than those in community-based arrangements and community detention. Conclusions Our findings highlight the exceptionally high rates of self-harm among detained asylum seekers compared to rates observed in the general Australian population, and among asylum seekers in community-based settings. These findings point clearly to the deleterious impact of immigration detention, and warrant urgent attention.

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Section: Discussionmentioning

confidence: 99%

Self-harm in the Australian asylum seeker population: A national records-based study

Hedrick

Armstrong

Coffey

et al. 2019

SSM - Population Health

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“…Given that most people who self-harm do not seek help (Rowe et al 2014), incarceration is a unique opportunity to identify self-harm history and initiate appropriate mental health treatment. Self-reported self-harm lacks sensitivity, however identification of people at risk of self-harm can be improved through combining multiple data sources, including community health records (Borschmann et al 2017). …”

Section: Discussionmentioning

confidence: 99%

“…First, we used convenience sampling, thus the prevalence reported here cannot be considered representative of the prevalence in the wider Australian prison population. Second, as self-harm is typically under-reported in the prison environment (Borschmann et al 2017), it is likely that we under-estimated the lifetime prevalence of self-harm. Disclosure of self-harm can be highly stigmatising (Mackay and Barrowclough 2005) and may result in increased correctional monitoring and restrictive interventions (Justice Health 2015).…”

Section: Discussionmentioning

confidence: 99%

Self-harm and suicidal behaviour among incarcerated adults in the Australian Capital Territory

et al. 2018

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BackgroundSuicide is the leading cause of death in prisons worldwide. Improved understanding of the factors associated with suicide is necessary to inform targeted suicide prevention and interventions. Here we aim to (a) document the prevalence of suicide attempts, suicidal ideation, self-harm, and mental disorder; and (b) identify demographic, mental health, and criminal justice correlates of suicidal ideation, in a sample of incarcerated adults in Australia.MethodsData were obtained from the 2016 Detainee Health and Wellbeing Survey conducted in the Alexander Maconochie Centre, the Australian Capital Territory’s only adult prison. Interviews with 98 incarcerated adults were conducted in October 2016. Descriptive statistics were calculated for all measures. Crude differences between participants who reported experiencing suicidal ideation in their lifetime and those who did not were compared using Fisher’s exact test.ResultsNearly half of the participants (48%, n = 47) reported lifetime suicidal ideation and 31% (n = 30) reported attempting suicide at some point in their lives. Eighteen participants (18%) reported a lifetime history of having engaged in self-harm. Factors significantly associated with suicidal ideation included lifetime history of mental disorder, self-harm, experiencing a drug overdose, and being hospitalized in the past 12 months.ConclusionThe burden of suicidal ideation and prior suicide attempts among people in prison is substantial. Incarceration is a pivotal opportunity to identify people with a history of mental health problems and target interventions aimed at reducing adverse outcomes including suicide mortality.

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“…Retaining people released from prison in survey-based longitudinal studies is notoriously challenging ( 72 ), but a methodology that holds promise is data linkage. Administrative data can be a valuable complement to self-reported data in both routine data collection and research, particularly when examining proscribed or stigmatized behaviors ( 14 , 32 , 35 , 72 ). Linkage with administrative health data also provides opportunities to accurately document the considerable costs of health care for people released from prison ( 73 ), which may assist in health economic analyses and in advocating for investments in primary and preventive health care for this population ( 74 ).…”

Section: Recurring Themes Evidence Gaps and A Way Forwardmentioning

confidence: 99%

Understanding and Improving the Health of People Who Experience Incarceration: An Overview and Synthesis

Kinner

Young

2018

Epidemiologic Reviews

123

110

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The world prison population is growing at a rate that exceeds the rate of population growth. This issue of Epidemiologic Reviews comprises articles in which researchers summarize what is known about some of the key health issues facing people in prison, particularly in relation to human immunodeficiency virus and other blood-borne viral infections. A key recurring theme is that addressing the health needs of people in prison is important to reducing health inequalities at the population level—that prisoner health is public health. The reviews also highlight some critical evidence gaps, notably the lack of evidence from low- and middle-income countries, and the limited number of longitudinal studies in which health behaviors, health outcomes, or health service experiences after release from prison are documented. Despite growing evidence of the poor health of detained adolescents, none of the included reviews considered this population. Further research on the health of young people who cycle through juvenile detention should be a priority. Despite a rapidly growing literature on the health of people who experience incarceration, some critical health issues remain poorly understood, and there has been insufficient attention devoted to co-occurring health conditions and the consequent need for coordinated care. Key populations in custodial settings remain understudied, limiting capacity to develop targeted, evidence-based responses to their health needs. The quality of many studies is suboptimal, and although rigorous, independent research in correctional settings can be challenging, it is not impossible and is critical to laying the groundwork for evidence-based reform.

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Accuracy and predictive value of incarcerated adults' accounts of their self-harm histories: findings froman Australian prospective data linkage study

Cited by 29 publications

References 57 publications

Self-harm in the Australian asylum seeker population: A national records-based study

Self-harm in the Australian asylum seeker population: A national records-based study

Self-harm and suicidal behaviour among incarcerated adults in the Australian Capital Territory

Understanding and Improving the Health of People Who Experience Incarceration: An Overview and Synthesis

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