title: National study of suicide in all people with a criminal justice history.
abstract: BACKGROUND
  Previous research has focused on suicide among male prisoners and ex-prisoners, but little is known about risk in the wider offender population.
  
  
  OBJECTIVE
  To examine suicide risk over 3 decades among all people processed by a national criminal justice system.
  
  
  METHODS
  Nested case-control study.
  
  
  METHODS
  The whole Danish population.
  
  
  METHODS
  Interlinked national registers identified all adult suicides during 1981 to 2006 according to any criminal justice system contact since 1980. Exposure was defined according to history of criminal justice adjudication, up to and including each subject's last judicial verdict before suicide (or date of matching for controls). There were 27 219 suicides and 524 899 controls matched on age, sex, and time, ie, controls were alive when their matched case died.
  
  
  METHODS
  Suicide.
  
  
  RESULTS
  More than a third of all male cases had a criminal justice history, but relative risk against the general population was higher for women than men. Independent effects linked with criminal justice exposure persisted with confounder adjustment. Suicide risk was markedly elevated with custodial sentencing, but the strongest effects were with sentencing to psychiatric treatment and with charges conditionally withdrawn. Risk was raised even in people with a criminal justice history but without custodial sentences or guilty verdicts. It was especially high with recent or frequent contact and in people charged with violent offenses.
  
  
  CONCLUSIONS
  We examined a section of society in which major health and social problems frequently coexist including offending, psychopathology, and suicidal behavior. The need for developing more far-reaching national suicide prevention strategies is indicated. In particular, improved mental health service provision is needed for all people in contact with the criminal justice system, including those not found guilty and those not given custodial sentences. Our findings also suggest that public services should be better coordinated to tackle co-occurring health and social problems more effectively.
authors.affiliation: Centre for Suicide Prevention, University of Manchester, Manchester, England. roger.webb@manchester.ac.uk
authors.forename: Roger T
authors.initials: RT
authors.lastname: Webb
authors.forename: Ping
authors.initials: P
authors.lastname: Qin
authors.forename: Hanne
authors.initials: H
authors.lastname: Stevens
authors.forename: Preben B
authors.initials: PB
authors.lastname: Mortensen
authors.forename: Louis
authors.initials: L
authors.lastname: Appleby
authors.forename: Jenny
authors.initials: J
authors.lastname: Shaw
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D003415:Crime / Q000331:legislation & jurisprudence / Q000523:psychology* / Q000706:statistics & numerical data; D003416:Criminal Law; D003718:Denmark / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012737:Sex Factors; D012919:Social Behavior; D012931:Social Environment; D013405:Suicide / Q000331:legislation & jurisprudence* / Q000523:psychology* / Q000706:statistics & numerical data; D055815:Young Adult