The relationship between age and suicidal thoughts and attempted suicide among prisoners

Abstract

Background: Suicide is a major problem across the lifespan, yet rates are highest among middle-aged and older adults; a trend which remains relatively stable across varying sociological settings, including prisons. Despite this understanding, there is limited knowledge on the nature of suicidal thoughts and attempts among older prisoners, especially with respect to how they compare to younger counterparts. The present study aimed to increase insight into the relationship between age and suicidal thoughts and attempted suicide among prisoners, with particular focus on factors that may explain age-based variability. Results: Cross-sectional data were drawn from a nationally representative sample of 18,185 prisoners housed within 326 prisons across the United States. In general, analyses revealed that: (a) attempted suicide was more commonly reported among younger prisoners, while suicidal ideation was more commonly reported among older prisoners; (b) the relationship between age and probability of reporting suicidal thoughts and behavior is curvilinear; (c) younger and older prisoners exhibit somewhat differing predictive patterns of suicidal thoughts and behavior (e.g., physical illness is directly associated with suicidal history for younger prisoners, whereas the effect of physical illness on suicidal history for older prisoners is mediated by depression). Conclusions: There is evidence to suggest that suicidal thoughts and behavior may manifest differently for younger and older prisoners, with differing patterns of risk. More research is needed on age-based variability in suicidal thoughts and attempted suicide among prisoners, as well as those factors that might explain this variability. Importantly, future research must continue to investigate the nature of suicidal thoughts and behavior among older prisoners.

Association of chronic diseases and lifestyle factors with suicidal ideation among adults aged 18–69 years in Eswatini: evidence from a population-based survey

“…Our findings are consistent with those of studies reporting that young age is associated with suicidal ideation [38,[57][58][59]. Most mental health problems, including suicidal ideation, occur among people in adolescence and are likely to persist through adulthood if not appropriately resolved [29,60].…”

The Heterogeneity of Suicide Attempters: An Analysis of Single- and Repeat-Suicide Attempters Among People in Custody

“…Race/ethnicity was based on a series of dummy variables: Hispanic, White, Black, and "Other" (i.e., Indigenous, Asian, Hawaiian/ Pacific Islander, or other race/ethnicity). A quantitative measure of age in years (16-84) was used, which was also squared (Age 2 ) to examine the possibility of a curvilinear effect of age on the probability of affirmative response on suicidal outcome measures (this approach is informed by Stoliker et al, 2020). Education is a quantitative measure that captured the highest level of school ever attended prior to the current incarceration (0-18).…”

“…It is worth noting, however, that suicidal outcome measures are linked to individuals' age at the time of the survey and not the exact age(s) at which suicidal events occurred. Given these findings and methodological shortcomings, researchers should further investigate agebased variation in repeat-versus single-suicidal behavior (separately for men and women)with particular focus on factors that might explain this variability (see Stoliker et al, 2020). In light of gender-based findings, it is evident that prison administrators will need to consider implementing gender-tailored risk assessment (Marzano et al, 2016) and psychological interventions (Fazel et al, 2016) to adequately address the specific needs of men and women who are incarcerated and at risk of (repetitive) suicidal behavior.…”

“…Relatedly, the gender paradox in suicide (Canetto & Sakinofsky, 1998) could bias analyses that compare men and women; nonetheless, the gender paradox is known to shift in the context of prison as men and women who are incarcerated show similar rates of completed suicide (Dye, 2011). Results for age may also be biased as suicide fatalities are more likely with increasing age (see Stoliker et al, 2020). Second, the self-report nature of the data presents some limitation as there is potential for biased recall, and individuals may be unwilling to provide accurate responses on sensitive items (Favril et al, 2020;Favril & O'Connor, 2021).…”

Challenges in providing ethically competent health care to incarcerated older adults with mental illness: a qualitative study exploring mental health professionals’ perspectives in Canada

“…In line with this concern, previous studies showed that suicidal ideation is mostly associated with weak social connections and depression resulting from, among other things, missing old connections and social life even after decades of incarceration [ 61 , 62 ]. Even though prison misconduct is inversely related to the offender’s age [ 2 ] and suicidal attempts are less common among older inmates as compared with younger offenders [ 63 ], suicidal ideation is rather currently more common among older prisoners and it is anticipated that suicide among the ageing population will be an increasing problem in the future [ 63 , 64 ].…”