Psychopathology, treatment, and gender in forensic mental health settings: Associations with suicidal behaviour
Previous research has highlighted the importance of mental health problems in suicide, particularly in the context of carceral or forensic institutionalization. Studies have suggested that specific measures for suicide prevention in institutions can be helpful, but there is little information on the relative importance and possible interactions between psychopathology, institutional treatment programs, gender, and the risk of suicidal behavior. The current study examined associations between these variables in a sample of 3,620 inmates in secure forensic mental health custody, with a total of 25,778 observations for the time under consideration. Linear logistic mixed models revealed that gender as well as the form and focus of treatment are significantly related to the occurrence of suicidal behavior. Males who had little access to treatment and were involved primarily in activities focused on social reintegration were at higher risk of suicidal behaviour. A diagnosis of schizophrenia without a co-occurring personality disorder was negatively related to suicidal conduct. These results contribute to clarifying the links between mental health, institution-based treatment, and suicidal behavior.