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In 2006, two grants were awarded by the NHS R&D Programme in Forensic Mental Healthto investigate near-lethal suicide attempts in prisoners. Suicide is the leading cause of death in prisons in England and Wales and places a considerable burden on prison and NHS resources. Yet studies of risk factors for suicide in prisoners have been limited to investigations based on records of prisoners who have died. Studying prisoners who have been involved in near-lethal suicide attempts provides the opportunity to investigate a much wider range of risk factors, including psychiatric, psychological and social factors. This is likely to provide a much fuller understanding of what contributes to suicide in prisoners. Using case-controlled methodology, 50 male and 50 female prisoners who have carried out near-lethal suicide attempts and 100 matched controls have been interviewed. This approach will contribute to our understanding of suicidal behaviour in prisoners and thus will assist NHS mental health in-reach teams and key workers in the prison system to implement suicide prevention measures.

Dr. Adrienne Rivlin and Dr. Lisa Marzano were the key researchers on this project, jointly supervised by Professor Keith Hawton and Dr Seena Fazel.



Keith Hawton, Seena Fazel, Lisa Marzano and Adrienne Rivlin with Madeleine Moon, MP for Bridgend, at the House of Commons on February 11th 2014 following their presentation on Self-harm and Suicide in Prisoners to the All Party Parliamentary Group on Suicide and Self-harm Prevention.

Publications on suicidal behaviour in prisons include:

Fazel, S., Cartwright, J., Norman-Nott, A., Hawton, K. (2008) Suicide in prisoners: a systematic review of risk factors. Journal of Clinical Psychiatry, 69, 1721-1731

Marzano, L., Rivlin, A., Fazel, S., Hawton, K. (2009) Interviewing survivors of near-lethal self-harm: A novel approach for investigating suicide amongst prisoners. Journal of Forensic and Legal Medicine, 16, 152-155.

Marzano, L., Fazel, S., Rivlin, A., Hawton, K. (2010) Psychiatric disorders in women prisoners who have engaged in near-lethal self-harm: a case-control study. British Journal of Psychiatry, 197, 219-226.

Rivlin, A., Hawton, K., Marzano, L., Fazel, S. (2010) Psychiatric disorders in male prisoners who made near-lethal suicide attempts: case-control study. British Journal of Psychiatry, 197, 313-319.

Marzano, L., Fazel, S., Rivlin, A. & Hawton, K. (2011). Near-lethal self-harm in women prisoners: contributing factors and psychological processes. Journal of Forensic Psychiatry & Psychology. doi:10.1080/14789949.2011.617465

Marzano, L., Hawton, K., Rivlin, A, & Fazel, S. (2011) Psychosocial influences on prisoner suicide: a case-control study of near-lethal self-harm in women prisoners. Social Science and Medicine, 72, 874-883. doi:10.1016/j.socscimed.2010.12.028

Rivlin, A., Marzano, L., Hawton, K. & Fazel, S. (2012). The impact on prisoners of participating in research interviews related to near-lethal suicide attempts. Journal of Affective Disorders, 136, 54-62. doi:10.1016/j.jad.2011.09.009

Rivlin, A., Ferris, R., Marzano, L., Fazel, S. & Hawton, K. (2013). A typology of male prisoners making near-lethal suicide attempts. Crisis. doi:10.1027/0227-5910/a000205

Rivlin, A., Hawton, K., Marzano, L. & Fazel, S. (2013). Psychosocial characteristics and social networks of suicidal prisoners: towards a model of suicidal behaviour in detention. PLOS ONE, 8, e68944. doi:10.1371/journal.pone.0068944