Characteristics of suicide attempts in a large urban jail system with an established suicide prevention program.
OBJECTIVE
The King County Department of Adult and Juvenile Detention in Washington State, like many jail systems across the nation, implemented a suicide prevention program in response to high suicide rates. A review committee was formed to prospectively study the patterns of suicide attempts that occurred in the system after the program was implemented and to make recommendations for improvements.


METHODS
All first suicide attempts per jail booking over a 33-month period in two of the department's jails were studied. For each attempt, characteristics of the individual and of the attempt were abstracted by trained staff.


RESULTS
A total of 132 first suicide attempts were made by 124 individual inmates during the study period. The prevalence of mental illness among inmates who attempted suicide was 77 percent, compared with 15 percent in the general jail population. Seventy-five percent of the inmates who attempted suicide had received a mental health evaluation from jail personnel before the attempt. Suicide attempts that were made in observation units for suicidal inmates (42 percent of all attempts), particularly those made in group observation units, necessitated fewer visits to an emergency department than those that occurred in general areas of the jail.


CONCLUSIONS
On the basis of these findings, the jails implemented interventions such as more suicide screening and treatment for inmates who have active substance abuse, greater consensus building in decisions about housing, and structural changes such as greater use of group-housing units and the use of barriers to prevent the inmates from jumping from balconies.
Goss
J Richard
JR
Department of Internal Medicine, University of Washington School of Medicine, Seattle, USA. rgoss@u.washington.edu
Peterson
Kari
K
Smith
Lawrence W
LW
Kalb
Kate
K
Brodey
Benjamin B
BB
D000328:Adult; D002391:Catchment Area, Health; D003415:Crime / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D008605:Mental Health Services / Q000458:organization & administration*; D011316:Preventive Psychiatry / Q000379:methods; D011329:Prisoners / Q000523:psychology* / Q000706:statistics & numerical data*; D011330:Prisons; D011446:Prospective Studies; D012934:Social Isolation; D012959:Socioeconomic Factors; D013406:Suicide, Attempted / Q000517:prevention & control* / Q000523:psychology / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology; D014505:Urban Population / Q000706:statistics & numerical data*