Not enough support is currently being offered to released offenders to prevent alcohol/drug abuse and suicide.
There has often been much focus on the need to reduce the risk of suicide in prisons. However, research into suicides by former inmates is "underinvestigated," according to a new study published in Sociology of Health and Illness.
Researchers from the University of Plymouth Peninsula School of Medicine and Dentistry in the UK - supported by the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care South West Peninsula - investigated the issue.
Released prisoners are often cited as a high-risk group in relation to suicide. A study published in 2007 on released US inmates found the risk of suicide was particularly high during the first 2 weeks.
Earlier this year, Medical News Today also reported how the large scale of deaths of former inmates was due to drug and alcohol abuse.
In the UK, statistics shows the age-adjusted risk of suicide for male offenders leaving prison is eight times the national average. In addition, over a quarter of fatal suicides occur within the first 4 weeks of release.
Suicides are also common for those under probation service supervision, with almost a quarter of deaths classified as suicide, often through violent means.
The individuals most at risk are those frequently in and out of prison; these individuals are also known as '"revolvers" and "churners." The constant change between life in prison and life in society can be challenging, and these repeat offenders can often fall between the cracks of society with little to no supervision and support at hand.
No associated link between suicide and previous life experience
To investigate, researchers interviewed 35 male offenders aged 18-52. Interviews were conducted in a semi-structured format and took place 1 week prior to their release and approximately 6 weeks after.
It was found the majority of prisoners experienced troubled personal lives; many reported histories of family breakdown or abandonment as a child, physical abuse or neglect and excessive drug and alcohol abuse in their family homes.
All interviewees reported recent personal problems, and just over half of the group - 18 of the 35 - had attempted suicide at some point in their lives. Those in this category could be divided into two groups: those who had attempted suicide multiple times and those who had only done so as a "one off."
It was found that former prisoners who had attempted suicide multiple times felt less in control of their situation and used less violent means. In contrast, individuals who had only attempted suicide once were more premeditated and used violent methods that were much more likely to result in a fatality.
Researchers found a lack of association between suicide attempts and previous life experience. Many former prisoners with no record of attempted suicide had suffered similarly traumatic experiences to those who had attempted suicide.
To create an effective support structure, the study recommends the incorporation of not only primary and secondary health care but support from drug and alcohol health care professionals. Also, greater aid is required for released inmates to deal with accommodation, employment and relationship issues.
Prof. Richard Byng, from the University of Plymouth Peninsula Schools of Medicine and Dentistry, hopes the research will see authorities examining the existing structure for released prisoners. He says:
"Care for those at risk of suicide will require not only a full assessment of risks and their needs, but also an acute understanding of where an individual is on the pathway to suicide. Our study suggests that there is a group of high-risk individuals with no previous attempt at suicide for whom identification and engagement is critical."
Under current arrangements in the UK, prisoners with sentences of less than 1 year receive minimal pre-release planning and no support by probation officers in the community.
This study follows on from the team's previous work in 2012, which was the first to systematically examine health care received by offenders across the criminal justice system in the UK. In similar fashion, the study found the existing structure contributed to poor ongoing access to mental health support.