title: Solitary confinement and risk of self-harm among jail inmates.
abstract: OBJECTIVE
  We sought to better understand acts of self-harm among inmates in correctional institutions.
  
  
  METHODS
  We analyzed data from medical records on 244 699 incarcerations in the New York City jail system from January 1, 2010, through January 31, 2013.
  
  
  RESULTS
  In 1303 (0.05%) of these incarcerations, 2182 acts of self-harm were committed, (103 potentially fatal and 7 fatal). Although only 7.3% of admissions included any solitary confinement, 53.3% of acts of self-harm and 45.0% of acts of potentially fatal self-harm occurred within this group. After we controlled for gender, age, race/ethnicity, serious mental illness, and length of stay, we found self-harm to be associated significantly with being in solitary confinement at least once, serious mental illness, being aged 18 years or younger, and being Latino or White, regardless of gender.
  
  
  CONCLUSIONS
  These self-harm predictors are consistent with our clinical impressions as jail health service managers. Because of this concern, the New York City jail system has modified its practices to direct inmates with mental illness who violate jail rules to more clinical settings and eliminate solitary confinement for those with serious mental illness.
authors: All authors are with the New York City Department of Health and Mental Hygiene, Queens, NY.
authors: Fatos
authors: F
authors: Kaba
authors: Andrea
authors: A
authors: Lewis
authors: Sarah
authors: S
authors: Glowa-Kollisch
authors: James
authors: J
authors: Hadler
authors: David
authors: D
authors: Lee
authors: Howard
authors: H
authors: Alper
authors: Daniel
authors: D
authors: Selling
authors: Ross
authors: R
authors: MacDonald
authors: Angela
authors: A
authors: Solimo
authors: Amanda
authors: A
authors: Parsons
authors: Homer
authors: H
authors: Venters
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D005260:Female; D006801:Humans; D008297:Male; D008485:Medical Audit; D001523:Mental Disorders / Q000453:epidemiology; D008875:Middle Aged; D015999:Multivariate Analysis; D009519:New York City / Q000453:epidemiology; D011329:Prisoners / Q000523:psychology*; D018570:Risk Assessment; D016728:Self-Injurious Behavior / Q000453:epidemiology / Q000209:etiology*; D017678:Sex Distribution; D012934:Social Isolation / Q000523:psychology*; D055815:Young Adult