Preventing suicide in jails and prisons

What this guideline says

GMJ summary

This WHO publication provides comprehensive guidance on preventing suicide among incarcerated populations, who face markedly elevated suicide risk—up to 8.5 times higher than the general population. The document synthesises evidence on screening, environmental modification, staff training, mental health services and post-incident responses specifically adapted to jails and prisons.

Key recommendations include universal mental health screening at intake and during high-risk periods (first 24 hours, after sentencing, following bad news), environmental safety measures to remove ligature points and means of self-harm, multidisciplinary staff training, crisis intervention protocols, and continuity of care during transitions. The guidance emphasises that suicide in custody is preventable through systematic policies combining architectural design, clinical care, staff vigilance and humane detention conditions.

The document stresses collaboration between correctional authorities, health services and mental health professionals, with special attention to vulnerable groups including young detainees, those with mental illness, substance use disorders, and those in isolation or facing long sentences.

Key points

For clinicians — doses and thresholds as stated in the guideline

1. Conduct mental health and suicide risk screening within 24 hours of admission for all detainees, using structured assessment tools and multidisciplinary input
2. Implement environmental modifications to remove ligature points, ensure safe cell design, and eliminate access to means of self-harm (sharp objects, toxic substances, medication stockpiling)
3. Train all correctional staff—not only health workers—in suicide risk recognition, crisis intervention, and appropriate response protocols
4. Establish constant observation protocols for high-risk individuals, avoiding prolonged solitary confinement which increases suicide risk
5. Provide timely access to mental health services including psychiatric evaluation, psychological support, and evidence-based treatment for depression, substance use and other conditions
6. Screen detainees aged 15–24 years with particular attention, as this age group shows elevated suicide rates in custody
7. Ensure continuity of mental health care during transfers between facilities and upon release, with follow-up within 7–10 days post-discharge
8. Implement post-incident protocols including psychological debriefing for staff and inmates, mortality review, and lessons-learned analysis after every suicide or attempt

From the guideline

Verbatim

“Suicide in prisons is preventable and prevention can be achieved through a combination of policies on adequate prison architecture, health services, staff training and general detention conditions.”

Editor’s perspective

Why this matters for Georgia and the region

Applicability

Georgia and the South Caucasus

Questions this guideline answers

Quick answers

Related on GMJ

Interconnected resources

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