Associations among Substance Use, Mental Health Disorders, and Self-Harm in a Prison Population: Examining Group Risk for Suicide Attempt.
Substance use disorders (SUD) and mental health disorders are significant public health issues that co-occur and are associated with high risk for suicide attempts. SUD and mental health disorders are more prevalent among offenders (i.e., prisoners or inmates) than the non-imprisoned population, raising concerns about the risk of self-harm. This cross-sectional study examined the population of a state prison system (10,988 out of 13,079) to identify associations among SUD (alcohol, cannabis, intravenous drugs, narcotics, and tobacco smoking), mental health disorders (anxiety, bipolar, depression, and psychotic disorders), and suicide attempts. The primary aim was to determine which groups (SUD, mental health disorders, and co-occurrences) were strongly association with suicide attempts. Groups with a documented SUD or mental health disorders compared to peers without these issues had 2.0 and 9.2 greater odds, respectively, for attempting suicide, which was significant atp< 0.0001 for both conditions. There were also significant differences within SUD and mental health disorders groups in regard to suicide attempts. Groups with the greatest odds for suicide attempts were offenders with comorbid bipolar comorbid and anxiety, alcohol combined with depression, and cannabis co-occurring with depression. Documentation of suicide attempts during imprisonment indicates awareness, but also suggest a need to continue enhancing screening and evaluating environmental settings.
Department of Family Medicine, Medical College of Georgia, Institute of Public and Preventive Health, Augusta University, 1120 15th Street, CJ 2300, Augusta, GA 30912, USA. mgates@augusta.edu.
Madison L
ML
Gates
Centurion, LLC, 53 Century Blvd, Suite 150, Nashville, TN 37214, USA. aturney@centuriontn.com.
Asher
A
Turney
Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, 997 St. Sebastian Way, Augusta, GA 30912, USA. elizabeth@frmrisk.com.
Elizabeth
E
Ferguson
Lexington Public Library, 3628 Walden Drive, Lexington, KY 40517, USA. vwalker@lexpublib.org.
Veronica
V
Walker
Georgia Department of Juvenile Justice, Central Office, 3408 Covington Highway, Decatur, GA 30032, USA. michellestaples-horne@djj.state.ga.us.
Michelle
M
Staples-Horne
D000328:Adult; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D005845:Georgia / Q000453:epidemiology; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000523:psychology*; D008875:Middle Aged; D011329:Prisoners / Q000523:psychology* / Q000706:statistics & numerical data; D012307:Risk Factors; D016728:Self-Injurious Behavior / Q000453:epidemiology / Q000523:psychology; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000523:psychology; D013406:Suicide, Attempted / Q000523:psychology*
mental health; prisoners; public health; self-injurious behavior; substance-related disorders; suicide; vulnerable population