Association of a History of Incarceration and Solitary Confinement with Suicide-Related Outcomes in a General Population Sample from Two U.S. Cities

Abstract

Objectives

To evaluate whether a history of incarceration was associated with increased odds of suicidal ideation and suicide attempts, and to determine if this association was further strengthened when combined with a history of solitary confinement.

Methods

We collected cross-sectional data from a general population sample in New York City and Baltimore in March 2017. Participants were categorized based on their history of incarceration and solitary confinement: (1) no incarceration, (2) incarceration-only, and (3) incarceration plus solitary confinement. We compared these three groups, utilizing hierarchical adjustments for sociodemographic factors and adverse childhood experiences. Missing data were accounted for utilizing multiple imputation via chained equation.

Results

A total of 1221 individuals were analyzed. Those who experienced both incarceration and solitary confinement consistently had higher odds of suicidal ideation (OR, 2.80; 95% CI, 1.43 to 5.48) and suicide attempts (OR, 6.98; 95% CI, 2.77 to 17.61) than never incarcerated individuals. Those who experienced incarceration without solitary confinement had higher odds of suicide attempts (OR, 3.77; 95% CI, 1.35 to 10.56) than never incarcerated individuals, whereas this association was not evident for suicidal ideation. Solitary confinement increased the odds of suicidal ideation even compared to incarceration without solitary confinement (OR, 2.71; 95% CI, 1.09 to 6.74).

Conclusions

Our findings support the need to address the higher likelihood of suicide-related outcomes among those in contact with the criminal justice system, and to consider alternatives to solitary confinement.

HIGHLIGHTS

• Those who experienced both incarceration and solitary confinement had higher odds of suicidal ideation and suicide attempts than never incarcerated individuals.

• Solitary confinement increased the likelihood of suicidal ideation, even more so than incarceration without solitary confinement.

Keywords:

• Criminalization
• health services
• jails
• prisons
• psychiatric epidemiology
• suicide

DISCLOSURE STATEMENT

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study was funded by an intramural research grant from the School of Social Work, University of Maryland (DeVylder).

Notes on contributors

Zui Narita

Zui Narita, Department of Behavioral Medicine, National Institute of Mental Health, Tokyo, Japan.

Hans Oh

Hans Oh, Suzanne Dworak Peck School of Social Work, University of Southern California, Los Angeles, CA, USA.

Ai Koyanagi

Ai Koyanagi, Parc Sanitari Sant Joan de Deu, Universitat de Barcelona, Fundacio Sant Joan de Deu, Dr Antoni Pujadas, Barcelona, Spain. Ai Koyanagi, ICREA, Barcelona, Spain.

Holly C. Wilcox

Holly C. Wilcox, Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.

Jordan DeVylder

Jordan DeVylder, Graduate School of Social Service, Fordham University, New York, NY, USA.