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Welcome to the EuroPris Knowledge Management System. The table below shows questions and responses from European National Agencies. Select a question for more information or use the filters on the left to narrow down questions based on Agency or Category.
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Introduction: From 2015 to 16 July of 2021 there have been 57 deaths by suicide in the prisons of Catalonia, where the prevalence of suicide in the prison system is higher than that in the community. In 2021, 8 inmates have committed suicide and this number is unfortunately higher than the average of 7 to 8 deaths by suicide per year that have been recorded in previous years. Taking into account that in 2020 11 inmates committed suicide, which represents 57% more than in 2019, this current year figures could indicate an alarming increase. The average of self-inflicted deaths in solitary confinement per year shows a changing trend since 2015. The lowest rate was recorded in 2017, when 12.5% of the total of self-inflicted deaths were committed in solitary confinement. The highest rate was recorded in 2019, when 57% of all suicides took place in solitary confinement. In addition, data shows that there is a higher trend of suicide among women than among men. In Catalonia, women represent 7% of the total prison population and yet, 17% of the suicides have been committed by women. Concerning suicide prevention, the Framework Programme for Suicide Prevention implemented in 2019 in all prisons in Catalonia, lays down the guidelines for setting up the suicide prevention protocol in every prison, as well as the implementation of the analysis sessions that should be conducted to address the aftermath and analyse suicide events already occurred. Both of this strands, the prevention protocol and the analysis sessions in the aftermath of the event, have the aim to improve the strategy to tackle the issue. Complementarily, the N’Viu programme, aims at preventing suicidal ideation and suicidal attempts, whereas the STEPPS programme is meant to prevent self-harming behaviour. Consequently, our increasing concern demands that we intensify and improve suicide prevention, intervention and the after the report strategies. This is why we would like to ask to other European prison administrations information about the following questions:
Rate per thounsand inmates/Number of suicides 2016 0.44/23 2017 0.52/27 2018 0.64/33 2019 0.85/43 2020 1.05/51 2021 (*) 0.62/30 (*)Estimated rate at the end of 2021 with data from the first semester.What has been the impact of the pandemic Covid-19 on this issue?
Unable to establish a relationship in the issue. There is no statistically significant difference between 2019 and 2020, continuing the previous upward trend. Significant decrease in the incidence rate estimated for 2021.Which prevention strategies and protocols do you implement?
The global prevention strategie is explained in the Instrucción 5/2014 (attached).Do you have any specific programmes for suicide prevention and intervention?
Previous answer.What after the report strategies and protocols do you implement?
Previous answer.Do you apply any specific methodology to analyse suicides and attempted suicides?
In the central services, there is an specific Working Group dedicated to analyse the cases. On the base on this work, specific indications are send periodically to the prisons.When you detect that an inmate is at risk, do you resort to another inmate so that s/he acts as the “support inmate” or “shadowing inmate” of the inmate at risk?
Answer number 3.Do you carry out any specific intervention with suicide survivors?
Answer number 3.
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Suicide rate over the last 5 years (prison population/ suicides): 2015 – 7603/8; 2016 – 6786/14; 2017 – 6704/5; 2018 – 6646/4; 2019 – 6285/7; 2020 – 5725/7What has been the impact of the pandemic Covid-19 on this issue?
Taking into account the number of suicides registered in 2020 as well as lockdown restrictions we presume that the pandemic had a negative impact.Which prevention strategies and protocols do you implement?
The algorithm of suicide and self-harm prevention in places of detention is approved by the order of the Director General of the Lithuanian Prison Department. Suicide prevention in places of detention involves the following steps: 1) psychosocial evaluation of an inmate at risk, 2) listing in a registrar of inmates at risk and preparing recommendations on supervision, communication and/ or accommodation of an inmate at risk, 4) regular psychological counseling re. suicidal crisis and suicide risk assessment, 5) at the end of the assigned recommendations, the psychologist shall advise the prison director on extension/ suspension of individual supervision. Seeking to ensure effective crisis management each prison has a Crisis management team, which is defined as a group of mental health professionals which organizes and supports sentenced inmates and pre-trial detainees in crisis.Do you have any specific programmes for suicide prevention and intervention?
See aboveWhat after the report strategies and protocols do you implement?
See aboveDo you apply any specific methodology to analyse suicides and attempted suicides?
Suicides and attempted suicides are analyzed according to the established standards.When you detect that an inmate is at risk, do you resort to another inmate so that s/he acts as the “support inmate” or “shadowing inmate” of the inmate at risk?
No, only individual supervision.Do you carry out any specific intervention with suicide survivors?
Yes, they are provided individual complex (psychological, social, medical) assistance. Professionals apply Collaborative Assessment and Management of Suicidality (CAMS).
In the attachment, there is a table with an overview of the incidence and evolution of suicides in the Slovak prison population for the last 5 years.What has been the impact of the pandemic Covid-19 on this issue?
Based on the results of examination of the suicide reasons of inmates we can state that in 2020, the pandemics of Covid-19 was not the reason of any of the suicides among inmates.Which prevention strategies and protocols do you implement?
Upon entry to pre-trial detention and prison sentence or during it, each inmate is scanned for any possible factors of the increased risk of suicidal act (e.g. first stay in the prison, addiction in the time of entry to prison, self-harm during previous stay in prison, mental illness and behaviour disorder or another serious psychical problem, death of a close person to which the inmate had a strong emotional bound, breakdown of marriage or another functional relationship or a sudden loss of social background etc.). At the same time, inmates upon entry take the entry screening questionnaire SBQ – R (The Suicide Behaviours Questionnaire), by means of which the suicidal trends screening in the past, attitudes in the present but also the potential risk of suicidal act of the inmate in the future are found out. If there is any of these factors or identified risk, the inmate is assigned to the first risk group within which the expert staff monitors in a targeted way the possible presence of the warning signals as e.g. changes in the communication content and way with other inmates and prison staff, retiringness and refusal of communication, tendency to provoke or take part in interpersonal conflicts, refusal to participate in the regular regime activity, getting rid of personal things and the like. In case of existence of any of these warning signals, such person is ordered the enhanced surveillance (second risk group). The enhanced surveillance includes the irregular control of movement and activity of this person at least every 30 minutes and targeted psychological interviews for the support of the protective factors against the self-injury and suicide act. In case the warning signals with high and immediate risk of suicide act occur, Prison Governor or another designated prison officer decides on classification to the third risk group and orders monitoring (continuous control of movement and activity of the inmate in the cell or room determined for it by the camera system, apart from the toilet and shower; if it is not possible to ensure the monitoring via the camera system, the monitoring includes also the continuous physical control of behaviour, movement and activities of the inmate according to the regime activity). Subsequently, the examination of this person by a doctor is ensured who considers the need to order other measures – e.g. provision of psychiatric health care in prison hospital, placement to a compensation cell and the like.Do you have any specific programmes for suicide prevention and intervention?
At the moment, the Corps of Prison and Court Guard of the Slovak Republic does not dispose of any specific compact or standardized programmes. However, there is elaborated a three-level system of suicide prevention (specified in point 3) carried out by the expert staff.What after the report strategies and protocols do you implement?
Transmission of information on the risk inmate takes place on two levels. The first one is within the internal communication of the prison staff, when changing shifts of the regime officers and their multidisciplinary cooperation. On the second level within the Information System of the Corps in which the course of the pre-trial detention or prison sentence is recorded, in the initial screen of the personal record of the inmate where the item “Risk level” is visibly marked with a recommendation of the psychologist. The information on previous suicidal attempts of the inmate is also stated and visibly stressed in the initial screen in the personal record of the inmate in the item “Important knowledge”.Do you apply any specific methodology to analyse suicides and attempted suicides?
No.When you detect that an inmate is at risk, do you resort to another inmate so that s/he acts as the “support inmate” or “shadowing inmate” of the inmate at risk?
In case an inmate is identified any warning signal indicating the possibility of suicidal ideations and act, we guide the inmates accommodated with the risky person in the room, cell or unit to the enhanced alertness against any untypical expressions in communication and behaviour of the inmate and informing the staff on such changes. However, the cooperation of inmates with the staff is always voluntary and has no official character (as e.g. gatekeepers).Do you carry out any specific intervention with suicide survivors?
Yes. Each inmate who tried to commit suicide, is placed in the psychiatric ward of the Prison Hospital and immediately after the attempt, he/she is provided the psychiatric and psychological intervention. After the end of the stay in this hospital, the inmate is placed back in a prison where the prison psychologist continues to provide the targeted intervention until the time when he/she evaluates, that there are no longer reasons for further intervention and the psychic condition of the inmate is stabilised for a long period.
Inmates in The Swedish Prison and Probation Service (SPSS) are a group in society where health problems are very common. Both physical and mental illness is common among clients in custody, prison and probation. Some belong to the risk group for self-harming acts and suicide. A report from 2014 that looked at suicide after completion of imprisonment showed that just the fact that a person has served time in prison increased the risk of suicide by 3 times. Through adaptations and control of premises and furnishings can risks in the physical environment be minimized. In the prison population, suicide is as common as in others society while the frequency is 3-4 times higher for clients placed in custody. In general, the mental strain is higher in custody and in closed environments where the physical room for maneuver is limited. Against this background, the Swedish Prison and Probation Service focuses in particular on addressing risks in residential areas in custody and prison. Experience shows that suicide in institutions and prisons is almost exclusively completed in living quarters and by the self-throttling method. Against this background, the Swedish Prison and Probation Service is working to standardize the living spaces so that they are designed in such a way that the possibilities for self-harm and suicide are minimized as far as possible. This happens, among other things by minimizing attachment points such as sink with faucet, lamp fixture, controls for blinds, hooks, door handles, shower racks and the like. The number of deaths among clients in the SPSS are relatively few per year. During the period 2012–2020 there were a total of 43 deaths in and out of custody and 54 deaths in and out of prison. Deaths outside the prison or institution can,for example, be when staying in hospital. Among the clients in custody almost half of all deaths were suicides. Among clients in the institution was about one of five deaths during the reported period suicide. In addition to suicide, the deaths may be due on, among other things, overdose, sudden death or death after long-term illness. During the period 2016-2020, there were a total of 5 suicides in custody and 2 suicides in prision.What has been the impact of the pandemic Covid-19 on this issue?
The pandemic in 2020 meant that many physical examinations were postponed and that personal meetings with clients decreased. The Swedish Prison and Probation Service's operational experts for health and medical care have assessed the extent to which the consequences of certain care being delayed have affected the state of health for The Prison and Probation Service's clients. This is currently difficult to assess, but there is much to suggest that it is did not have any serious consequences. No impact has been detected on this specific matter.Which prevention strategies and protocols do you implement?
The Swedish Prison and Probation Service's suicide prevention work aims to promote good life chances through individually designed interventions, but also focuses on identifying and addressing risks around individual clients and in physical environments. Suicide and self-harm among the Swedish Prison and Probation Service's clients is prevented through efforts at all levels of the authority. The head office is responsible for method development and national standardization regarding the authority's suicide prevention work. Through supervisory activities and incident investigation work, risks are identified and addressed at both local and national level. The head office's responsibilities also include planning and implement competence development initiatives. The Department of Prison and Custody, which is one of the departments of the head office under which all the prisons and institutions are organized, coordinates the SPSS's strategic work. Places of business (custody, prisons and probation office) is responsible for compliance with national suicide prevention procedures and to draw attention to and address risks from a local perspective.Do you have any specific programmes for suicide prevention and intervention?
The Swedish Prison and Probation Service's handbook for suicide prevention, 2012:12 functions as a national support for employees in client-related activities. The handbook focuses on preventive work, how suicide can prevented and prevented. The goal is to ensure that there is knowledge of, and routines about how the suicide prevention work should be conducted. The Swedish Prison and Probation Service's healthcare identifies risk factors for suicide by first using the CSSR-Clinical Practice Screener (Columbia Suicide Severity Rating Scale) and, if the risk is identified, the C-SSR Baseline is used. The instruments are used routinely and the Swedish Prison and Probation Service's nurses are trained in them.What after the report strategies and protocols do you implement?
All clients who are admitted to a custody or prison run by the Swedish Prison and Probation Service must undergo a structured assessment of the risk of self-harming action and suicide. The initial assessment may later need to be followed up as individual events related to enforcement or to the life situation in general, may involve changed and increased risk. When enrolling in custody or prison, a protective visitation is conducted on the client as well as change of clothes, if the client wants. If he wants to wear his private clothes and there is a risk of self-harming act or suicide, special emphasis is placed on the client not wearing clothing which can be used as a means of suicide (ex. belt, elastic shoelaces). Staff in custody and prison must have good knowledge of the clients and pay attention for example, change in mood. When risks, needs and receptivity are assessed during the preparation of the client's enforcement plan, questions about suicide are asked. This aims to draw the investigator's attention to whether there is a risk of self-harming acts or suicide and whether assessment of health care is required. If the assessment indicates risk of suicide decision-makers need to be informed and action taken. If necessary the SPSS ordinates so-called second surveillance. Then the client is monitored around the clock. If the SPSS assesses that a client needs psychiatric assessment or care he or her is transported to a psychiatric clinic. Clients transported by the national transport unit (NTE) are assessed for risk for self-harming act and suicide at the respective place of business before and after transport.Do you apply any specific methodology to analyse suicides and attempted suicides?
After serious incidents, such as suicide or suicide attempts by a client, the Swedish Prison and Probation Service conducts an incident investigation. The purpose of investigating an incident or other serious incident is to clarify a course of events and identify its underlying causes, to take measures to reduce the risk of a similar incident being repeated, both at the place of business where the incident occurred and within the Swedish Prison and Probation Service in general. An investigation also aims to disseminate good examples of the work carried out in connection with an incident.When you detect that an inmate is at risk, do you resort to another inmate so that s/he acts as the “support inmate” or “shadowing inmate” of the inmate at risk?
No.Do you carry out any specific intervention with suicide survivors?
The fact that a person has previously made one or more suicide attempts is the single strongest risk factor for future suicide. The risk of suicide is greatest during the first year after the attempt, but remains even later. Individuals who have attempted suicide before or during their time in the Swedish Prison and Probation Service thus have a higher risk of future suicide during their time in custody. A client who during the past month has made an suicide attempt is placed under constant supervision. A client who has made a suicide attempt in the last 12 months is placed under irregular supervision (irregular at least four times an hour, however, no more than 15 minutes may elapse between the supervised sessions). The purpose of irregular supervision is to reduce the opportunities for the client to anticipate the supervision and thus make it more difficult for him or her to commit suicide.
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In England and Wales our Safety in Custody statistics measure self-inflicted deaths. The statistics report self-inflicted deaths as “any death of a person who has apparently taken his or her own life irrespective of intent. This not only includes suicides but also accidental deaths as a result of the person’s own actions. This classification is used because it is not always known whether a person intended to commit suicide”. The table below shows the numbers of self-inflicted deaths, and the rates per 1,000 prisoners, over the last five years: Dec-15 Dec-16 Dec-17 Dec-18 Dec-19 Dec-20 Total self-inflicted deaths 90 124 73 92 85 67 Self-inflicted deaths per 1,000 prisoners 1.1 1.5 0.9 1.1 1.0 0.8 This data shows that there was a comparatively high number of self-inflicted deaths in the 12 months to December 2016 with an incident rate of 1.5 self-inflicted deaths per 1,000 prisoners. This rate has fluctuated from 2017 onwards, deceasing to a rate of 0.8 deaths per 1,000 prisoners throughout the 12 months to December 2020. However, caution is required in drawing conclusions due to the small numbers referenced.What has been the impact of the pandemic Covid-19 on this issue?
We recognise that anxieties regarding Covid-19 and the regime restrictions required for infection control may have increased the risk of self-harm and self-inflicted deaths. Whilst the rate of self-inflicted deaths has decreased during the pandemic, rates for self-harm have shown a mixed picture, deceasing in the male estate but increasing in the female estate. Causes for increases and decreases cannot be attributed to one single driver or protective factor; however, we know that Covid-19 has impacted risks, triggers and protective factors for many within our prison population.Which prevention strategies and protocols do you implement?
Since the pandemic started, we have produced a range of products to help prisons mitigate the risk of self-harm, including tailored guidance for supporting specific groups of people in prison whose wellbeing may be more impacted by Covid-19 measures. This includes older prisoners, those with learning disabilities and/or autism, transgender prisoners, and groups known to be at increased risk of self-harm, suicide or violence. Each prisoner has a key worker to provide one-to-one support and give them an avenue to discuss those issues which, without support, may lead to self-harm. Regular key work sessions also mean that staff are aware of issues earlier and may be able to provide the right support early before they become greater problems. Where Covid-19 has impacted the delivery of keywork sessions, we have introduced wellbeing checks to ensure continued staff / prisoner interactions. To mitigate the impact of the regime restrictions that have been required in response to Covid-19, we have produced materials to support wellbeing at this particularly difficult time, including a range of in-cell activities and a wellbeing plan (a self-help tool that can be used by residents to reflect on their triggers and coping strategies). We also continue to fund the Samaritans excellent Listeners scheme, through which selected prisoners are trained to provide emotional support to their fellow prisoners. Where face-to-face interactions have not been possible due to covid, we have provided access to the Samaritans by telephone.Do you have any specific programmes for suicide prevention and intervention?
Assessment, Care in Custody and Teamwork (ACCT) is a multi-disciplinary case management system used in prisons to support people at risk of suicide and self-harm. On any given day, ACCT supports over 2,000 prisoners who have been assessed as being ‘at risk’. In July this year we rolled out revisions to ACCT across the prison estate. Revisions include a stronger emphasis on ensuring a person-centred approach; enhanced multi-disciplinary team working; a consistent quality assurance process and an improved focus on risks, triggers, and protective factors. We have a programme of training for current and new prison staff, which includes modules on Mental Health and on Self-Harm and Suicide Prevention. We are developing further modules which will focus on communication skills and on understanding risk factors.What after the report strategies and protocols do you implement?
Our policy is that, following a self-inflicted death, “appropriate care and support must be offered to the cell-mate and any other prisoners directly affected by the death, including all those on open ACCT documents”. Following each self-inflicted death, safety teams carry out a review to ensure emerging issues are noted so that immediate action can be taken. Learning from these reviews helps to inform the development of policy and guidance. We have recently worked with the Samaritans to increase support for prisons following a self-inflicted death. This helps us provide clear information to staff and prisoners in a personal and sensitive way, including signposting to additional support, and to provide additional training for our Listeners so they can offer enhanced support to prisoners.Do you apply any specific methodology to analyse suicides and attempted suicides?
We publish our Safety in Custody statistics on a quarterly basis, which includes total numbers of deaths and total numbers of self-inflicted deaths, as well as rates per 1,000 prisoners. We provide comparisons for both the previous quarter and the previous 12 months, as well as comparisons for the same quarter of the previous year. We break down our statistics by gender and by status (e.g. remand or sentenced prisoners). All data for self-harm is analysed in the same way and we also include the data for the different methods of self-harm, including for “serious self-harm incidents requiring hospital attendance.” Additionally, all self-inflicted deaths are investigated by the Prisons and Probation Ombudsman who provide a report which may also make recommendations. We consider the learning from these cases so they can be shared with prisons to prevent other deaths.When you detect that an inmate is at risk, do you resort to another inmate so that s/he acts as the “support inmate” or “shadowing inmate” of the inmate at risk?
We don’t currently have a “support inmate” process in place specifically for prisoners at risk of suicide. However, we operate the Listeners peer support scheme with the Samaritans, where a vulnerable prisoner can request to meet with a Listener who can provide confidential emotional support.Do you carry out any specific intervention with suicide survivors?
Any prisoner who has attempted to take their own life would be supported by the Assessment, Care in Custody and Teamwork (ACCT) multi-disciplinary case management system as outlined in question 4.
Statistics of suicides in Norwegian prisons the last years: 2020 -2 2019-6 2018-2 2017-3 2016-5What has been the impact of the pandemic Covid-19 on this issue?
We see no impact of the Covid 19 pandemic.Which prevention strategies and protocols do you implement?
• Information about the risk of suicide is often brought to the prison from the outside. This could be informed us from the inmate him/herself during the start-interview by arrival, it could be handed over by the police or prosecution, or the health-service through their knowledge of the inmate from earlier. • Observation by the staff, sharing impressions, information and judgments with colleagues and health staff in prison is a prior element in the dynamic security in all prisons. • Mapping and further interviews of individual inmates is to be done according to the guidelines, an individual action-plan is to be made and in most cases shared with staff from the health-service for a further professional treatment by health-staff. • Competence by all the prison staff, on the issue to prevent suicides, have been enhanced the last years in all Norwegian prisons, as well as at the academy for prison officers.Do you have any specific programmes for suicide prevention and intervention?
The program is defined in the guidelines, ref. question no 3. • Human relation is obviously the most important impact in case a suicidal situation occurs. The number of staff close to the inmates is a major factor. • Dynamic security is a main part of the professional standard, and this is focusing directly to the issue of individual inmates change of mental situation. All operating staff has to be aware and keep a close focus on the issue of suicide among inmates.What after the report strategies and protocols do you implement?
In case of serious cases of suicide or attempts of suicide, a report for deviation must be made. This is thoroughly analyzed by superior level in each region, as well as the Directorate of Corrections. Evaluation and feedback are always followed up to the prison of the occasion/ incident. National adjustments can also easily be registered this way.Do you apply any specific methodology to analyse suicides and attempted suicides?
Yes, a standard set of rules are to be followed according to the guidelines, ref above.When you detect that an inmate is at risk, do you resort to another inmate so that s/he acts as the “support inmate” or “shadowing inmate” of the inmate at risk?
Usually staff is taking care of the situation together with the health-care personnel. Other inmates can represent important and close “person to person” - relation, but in general this is a matter of mental health, and the issue is very high complexity. Too often even highly professional treatments does not prevent suicides to happen.Do you carry out any specific intervention with suicide survivors?
Yes, Attempted suicides are looked at very seriously and this is followed up by health-service, and professionally communicated to the prison staff, according to the prison guidelines, and professional health-care.
From 2015 to 27 August 2021, there have been 63 suicide attempts and 26 cases of completed suicide by prisoners in prisons of the Republic of Latvia (please see the table). The number of suicides in prisons is not higher than in the society and in 2016-2018 did not stably exceed 1% of the total number of suicides registered in the country. In previous years, an average of 3 suicides per year were registered in prisons of the Republic of Latvia, however, in 2020 the number of suicides committed by prisoners increased significantly and amounted to 7 suicides per year, which, similarly to Catalan prisons, is 57% higher than in 2019. Also, the number of registered suicides in the first half of 2021 is also higher than the average number of suicides per year in previous years. Number of suicide attempts: in 2015 – 11; in 2016 – 8; in 2017 – 8; in 2018 -13; in 2019 – 7; in 2020 – 10; in 2021 (as on 30 August 2021) – 6. Number of completed suicide cases: in 2015 – 4; in 2016 – 3; in 2017 – 3; in 2018 – 2; in 2019 - 3; in 2020 - 7; in 2021 (as on 30 August 2021) - 4. Number of suicides committed in society: in 2015 – 386; in 2016 – 364; in 2017 – 354; in 2018 – 299; in 2019 – 288; in 2020 – 297; in 2021 (as on 30 August 2021) – 110 (data as of June 2021). Proportion of suicides committed in prisons: in 2015 – 1,04%; in 2016 – 0,83%; in 2017 – 0,85%, in 2018 – 0,67%; in 2019 – 1,05%; in 2020 – 2,41%; in 2021 (as on 30 August 2021) – 3,77%. From 2015 to August 30 2021, 100% of suicides were committed by men, of which 81% were committed by men detainees. The mentioned data clearly show that among men, especially among men detainees, there is a higher tendency of suicide than among women (imprisoned women in the Republic of Latvia make up 8% of all prisoners). The most common method of suicide for prisoners is intentional self-harm by hanging (92% of cases), 2% is intentional self-harm with a sharp object.What has been the impact of the pandemic Covid-19 on this issue?
The Latvian Prison Administration (hereinafter – Administration) does not have research data on the impact of the COVID-19 pandemic on prisoners' suicide attempts. It is possible that the number of suicide attempts and completed suicides of prisoners was influenced by the restrictions related to the declaration of a state of emergency, incl. limited opportunity to meet relatives in person, as well as a decrease in the number of face-to-face resocialisation measures.Which prevention strategies and protocols do you implement?
In 2016, the “Guidelines for the Latvian Prison Administration and Prisons for the Prevention of Suicidal Behaviour of Prisoners” (hereinafter - the Guidelines) were implemented in practice. Currently, work is underway to improve the above-mentioned Guidelines - in 2020, a new tool for evaluating the suicidal behaviour of prisoners was developed and tested, in 2021 work continues on improving prevention processes.Do you have any specific programmes for suicide prevention and intervention?
In 2020-2021, within the framework of the European Social Fund project No. 220.127.116.11/16/I/001 “Increasing the Efficiency of the Resocialisation System” a new resocialisation program “I am aware” for prisoners with a tendency to suicidal behaviour has been developed. The program is based on the basic principles and methods of Dialectical Behavioural Therapy (DBT). It is planned to acquire three basic skills within the framework of the program that helps to reduce the flashes of emotions and keep a cool mind when emotions prevail - the practice of awareness, regulation of emotions, interpersonal relationships. The aim of the program is to promote the development of communication and emotional self-management skills in order to enhance self-awareness and the ability to form interpersonal relationship. Prison staff is currently being trained to work with this program. In addition, the normative acts regulating the execution of detention and custodial sentence stipulate the provision of an immediate psychological assistance to a prisoner, but not later than on the next working day after receiving the information or order of the Head of the prison, if the prisoner has attempted a suicide.What after the report strategies and protocols do you implement?
The operation algorithm of Administration and its structural units upon receiving information about the prisoner's suicidal behaviour (threat, suicide attempt, completed suicide) is described in the Guidelines (available in English on the EuroPris website).Do you apply any specific methodology to analyse suicides and attempted suicides?
Tendencies of the prisoners' suicidal behaviour are analyzed annually on the basis of the following criteria: - the total number of suicidal behaviour of prisoners; - the number of unique prisoners with suicidal behaviour; - the number of prisoners registered as suicidal; - number of cases of suicidal behaviour, broken down by type of suicidal behaviour (suicide threat, self-harm, suicide attempt, suicide) and types of self-harm (intentional injury by hanging, intentional self-harm with a sharp object, intentional self-harm with blunt object, intentional self-harm by other specified means, intentional self - harm by other unspecified means); - the number of suicidal behaviour cases, divided by the sex, age and status of prisoners (detainee, inmate). In addition to the above criteria, the following factors are taken into account in the analysis of prisoners' suicide cases: - whether the prisoner has been registered as a suicidal person; - in which prison and when (month, day of the week, at what time) suicide was committed; - Articles of the Criminal Code under which the prisoner was accused or convicted.When you detect that an inmate is at risk, do you resort to another inmate so that s/he acts as the “support inmate” or “shadowing inmate” of the inmate at risk?
When detecting that an inmate is at risk, we do not resort to another inmate so that s/he acts as the “support inmate” of the inmate at risk.Do you carry out any specific intervention with suicide survivors?
Prisoners, who have survived suicide attempts, are involved in individual consultations of a psychologist, in the Resocialization Program for Stress Reduction and Improvement of Social Skills, in the future the prisoners will be involved in the resocialization program "I am aware" (after the implementation of the program in practice), support group.
Suicides in prisons and local prisons in Denmark Suicide 2020 2019 2018 2017 2016 In prisons 4 10 5 4 8 and local prisonsWhat has been the impact of the pandemic Covid-19 on this issue?
Pandemic Covid – 19 has not had an impact on the result.Which prevention strategies and protocols do you implement?
During the training to become a correctional officers, the students have “theme day” regarding suicide prevention. During that day the students are taught about the different circumstances which can make an inmate suicidal, they are taught to recognize characteristics, risk factors and danger signals pointing toward suicide, and they are taught different opportunities for action when dealing with an suicidal inmateDo you have any specific programmes for suicide prevention and intervention?
See question 3What after the report strategies and protocols do you implement?
See question 6Do you apply any specific methodology to analyse suicides and attempted suicides?
All cases of death, suicide, and suicide attempts and other qualified self-harm situations and actions are by rules reported to both the Danish Prison and Probation Service and the Ombudsman whom both have the supervisory duties for prisoners in the prison custody. Thus, through a reporting system, the four region offices (Denmark is regarding the Danish Prison and Probation Service, divided in four regions) supervise the institutions' treatment of death, cases of suicide, suicide attempts and other qualified self-harm situations related to a prisoner's detention. Through the reporting system, it is ensured in particular, that experience from specific cases is involved in preventive action in this area as well as checking how the institution has handled the incident in question, including whether a malfunction has been committed by the staff.When you detect that an inmate is at risk, do you resort to another inmate so that s/he acts as the “support inmate” or “shadowing inmate” of the inmate at risk?
NoDo you carry out any specific intervention with suicide survivors?
Number of suicide cases in the last 5 years: 2016 - 6 2017 - 3 2018 - 6 2019 - 9 2020 - 7 We note, that most of the cases of suicide recorded in the prison system are committed in pre-trial facilities, mostly caused by the detention shock, difficulties of accommodation to the conditions, detention regime, as an impulsive-revengeful act, loss of control over situations (get smaller in personal independence in decision making, the necessity to submit to the rules of institution), the loss of hope in achievement of "justice", in protest of court decisions, the consumption of alcohol/toxic substances, an act determined by mental ill-health (psychiatric).What has been the impact of the pandemic Covid-19 on this issue?
There was no a significant impact of the Covid-19 pandemic on the mental health and emotional state of the inmates, which can be observed from the evolution of the suicide rate in the penitentiary system during the last 5 years.Which prevention strategies and protocols do you implement?
One of the tasks of the psychologists within the penitentiary institutions is to diminish the suicidal phenomenon among the inmates and efforts are constantly made to reduce the self-mutilation actions and suicide attempts among the inmates. As a result, quarterly in the penitentiary institutions is drawn up the list of persons with a high risk, including those prone to self-harm and suicide, which is presented for information to the head of institution and competent services within the penitentiaries, according to an Instruction on organizing and carrying out the psychological activity with inmates belonging to the risk group. Thus, the identified persons are included in various prophylactic, individual and group activities focused to an intervention in identifying irrational thoughts and behavioural change, as a result of recording. Also it was imposed the necessity of some activities for the promotion of mental health. Thus, with the support of the CoE, within the "Program of Council of Europe promoting a human rights compliant criminal justice system in the Republic of Moldova " in 2020 it was developed the Mental Health Strategy within the Penitentiary Administration System of the Republic of Moldova for 2021- 2023, with an Action Plan, including the Suicide Prevention and Self-mutilation Policy, were have been foreseen a series of prevention and intervention measures in case of suicide attempts.Do you have any specific programmes for suicide prevention and intervention?
In this context, there is the General Rehabilitation Program which has been developed by the consultants of the Council of Europe (CE), in consultation with the specialized directorates of the National Administration of Penitentiaries (NAP) and subordinate institutions. The activity took place within the Program "Promoting a human rights compliant criminal justice system in the Republic of Moldova" funded by the Government of Norway and implemented as part of the Council of Europe Action Plan for the Republic of Moldova 2017-2020. The general objective of the program was to ensure respect for human rights and the rule of law, by assisting national authorities in building an effective criminal justice system, based on the principles of humanization, resocialization and restorative justice. This program is to be piloted in all penitentiary institutions in the country, including the provision of more demands and risks of inmates, including suicide-prone inmates, with including in individual hearings. In order to prevent the occurrence of unwanted incidents, the psychologist carries out with each newcomer an initial psychological assessment in quarantine, which is performed through the structured or semi-structured interviews to determine the psycho-emotional state and suicide risk factors. Psychological counselling is carried out with inmates in crisis situations (refusal of food, self-mutilation, suicide attempt, death of close relatives, etc.), depending on identified problems, by a specialized psychologist.What after the report strategies and protocols do you implement?
The service units of the penitentiary institutions inform immediately through the Informative Notes about the cases of self-mutilation, suicide attempt and / or suicide the hierarchically superior institutions and organisations that contribute to the defence of the fundamental human rights and freedoms. The Penitentiary Administration System in Moldova has a prevention and intervention policy in cases of suicide and self-harm, which includes several services. In the last 2 years, the procedure regarding the intervention of the penitentiary staff in cases of self-mutilation, suicide attempt and refusal of food declared by the detainees has been reviewed, and another procedure for recording and rehabilitating persons at risk of suicide will be subject to review and modification, or self-harm in prisons.Do you apply any specific methodology to analyse suicides and attempted suicides? When you detect that an inmate is at risk, do you resort to another inmate so that s/he acts as the “support inmate” or “shadowing inmate” of the inmate at risk?
NoDo you carry out any specific intervention with suicide survivors?
Specific interventions shall be mentioned in internal instructions approved as procedures by the Director of the NAP. Thus, the activity of the specialist responsible for the psychological activities, with survivors of attempts to suicide, includes several measures, such as the determination of the causes (psychological methods may be used) that led the inmates to commit the suicidal attempt; conduct psychological and psychotherapeutic counselling meetings, aimed for changing life options, changing the perceptions of the inmate, etc.; collaboration with the psychiatrist as appropriate; develop methodical recommendations for prison staff on individual work and treatment of inmates with risk of injury.
2015 2016 2017 2018 2019 2020 16 12 13 16 12 14What has been the impact of the pandemic Covid-19 on this issue?
The pandemic and lockdown had an undeniable impact on the mental well-being of citizens in a free society. They also had an impact on the prison population, bearing in mind that this population was already generally characterised as vulnerable in different areas of life even before the health crisis caused by COVID-19. In 2020, 14 prisoners ended their lives. That's two suicides more than in 2019, but two less than in 2018. The suicide rate for 2020 was 13.48 per 10,000 inmates, compared to 15.59 in 2018 and 11.36 in 2019. There was therefore no significant increase despite the lockdown measures. The medical and psycho-social services maintained contact with prisoners and increased their vigilance during the health crisis. Prisoners also increasingly turned to these internal services to talk about their concerns caused by the health crisis. Finally, since the beginning of the lockdown introduced to combat the COVID-19 pandemic, several organisations have provided freephone numbers to make it easier for prisoners to talk to someone. I am thinking, for example, of the Muslim Executive of Belgium and the various services providing support to prisoners.Which prevention strategies and protocols do you implement?
Suicide is a complex and sensitive issue and suicide prevention in prisons is a complex matter involving various initiatives and different agencies, including the Communities in the framework of assistance to persons. The various initiatives taken by DG EPI on its own and together with external partners in the field of suicide prevention shape the current policy. Suicide prevention is part of the day-to-day policy at correctional facilities. Increased vigilance by the medical and psycho-social services when receiving a prisoner and at each subsequent contact is part of the standard procedure. When they notice signs that a prisoner might be suicidal, they report it to the prison management and to the guards for the prisoner to be observed more closely (including at night). There are written instructions on visual monitoring and procedures when suicidal behaviour is detected. The prison officers (PBA in Dutch) also play an important preventive role. When they observe suicidal behaviour, they immediately refer the prisoner to the competent authority (prison management, psycho-social service or care team) so that preventive safety measures may be taken. In the case of suicidal prisoners, the psycho-social and medical services, as well as the prison management, ensure more active monitoring and consultation. Furthermore, a referral is always made to the services of the Flemish Community for assistance. Given the important role of prison staff in suicide prevention, this topic also receives special attention during their training. As part of their basic training, prison officers receive seven hours of suicide prevention training. This training focuses, among other things, on detecting signs of suicidal tendencies, reporting them and responding appropriately. This course was fully updated with the help of the Flemish Expertise Centre for Suicide Prevention. In addition, the training centres for prison staff also organise a two-day 'suicide prevention' flash training course, which is open to all DG EPI staff. This training can be organised at the request of a local institution or when there are enough staff members on the waiting list. A train-the-trainer training course was also organised in 2016 on conversation techniques as part of suicide prevention. Since 2017, the section on "interview techniques" has been included in the two-day "suicide prevention" flash training and is therefore accessible to all staff. Prisons also pay attention to suicide prevention, both structurally and on an ad hoc basis. Within DG EPI, a multidisciplinary working group is working on this topic with the aim of developing general instructions supplemented by guidance for staff. DG EPI has also launched its own institution-related initiatives and cooperates structurally on suicide prevention with the Communities' services as it also falls within their remit. On the Flemish side, there is also cooperation with the Centres for Mental Health Care in various prisons, and on the Walloon side with the assistance services "services d'aide aux justiciables". Prisoners also have access to the free suicide line 1813 of the Centre for the Prevention of Suicide and to the crisis line of the Centre de Prévention du Suicide. The Flemish Community has also developed a flyer for the prison services on suicide prevention (what to do when signs are observed) and help and care providers working in prison can also contact the ASPHA line of the Centre for the Prevention of Suicide for advice on suicide prevention. The Flemish acronym ASPHA stands for Suicide Prevention Advice for General Practitioners and Other Care Providers. They can contact ASPHA by telephone or e-mail for advice on counselling suicidal persons, their environment and next of kin regarding suicide. The Flemish Mental Health Centres are also working on a "suicide prevention script" for Flemish prisons. In addition, DG EPI cooperates intensively with the Tandem operation. This new service "Referral and Registration after Detention and More" is subsidised by the Flemish Department of Welfare and aims to more efficiently guide prisoners with mental health problems (including addiction problems and sexual offenders) to assistance services in normal society.Do you have any specific programmes for suicide prevention and intervention?
As mentioned above, special measures are taken when signs are noticed at intake or by a PBA that a prisoner might be suicidal. They report this to the prison management and to the guards so that the prisoner can be observed more closely (including at night). There are written instructions on visual monitoring and procedures when suicidal behaviour is detected. The prison officers also play an important preventive role. When they observe suicidal behaviour, they immediately refer the prisoner to the competent authority (prison management, psycho-social service or care team) so preventive safety measures may be taken. In the case of suicidal prisoners, the psycho-social and medical services, as well as the prison management, ensure more active monitoring and consultation. Furthermore, a referral is always made to the services of the Flemish Community for assistance. Prisoners also have access to the free suicide line 1813 of the Centre for the Prevention of Suicide and to the crisis line of the Centre de Prévention du Suicide.What after the report strategies and protocols do you implement?
I am unable to answer thisDo you apply any specific methodology to analyse suicides and attempted suicides?
Every suicide attempt is discussed internally (debriefing) at the level of safety aspects and control, and is also discussed medically (medical debriefing) to make an analysis of the elements that may have led to the attempt or actual suicide.When you detect that an inmate is at risk, do you resort to another inmate so that s/he acts as the “support inmate” or “shadowing inmate” of the inmate at risk?
Each case is considered individually. Placement in a duo cell is one of the most effective measures to minimise the time spent alone in the cell. The presence of a cellmate has a protective effect: suicidal acts are less likely to be committed because of the social pressure created by the presence of a cellmate; also, the cellmate is likely to raise the alarm if a prisoner acts on his suicide intentions.Do you carry out any specific intervention with suicide survivors?
In the case of signs of suicidal behaviour and attempted suicide, an active monitoring is ensured by the medical and psycho-social services and the prison management, and the prisoner is referred for assistance by the Communities. This monitoring should be evaluated frequently to see if and when it can be scaled back. After a successful suicide or a serious suicide attempt, consideration is given to who, in addition to the prisoner concerned, can best be offered care and how this is to be organised. This may include the cellmate, a friend, prisoners known to be at risk of suicide, prisoners whose suicide risk appears to have subsided but who have been monitored by the hotline in recent months, ....