Changes in male suicides in Scottish prisons: 10-year study.

BACKGROUND: In 1999 I estimated the expected number of UK prison suicides, taking into account that opioid users' deaths from suicide were 10 times the number expected for their age and gender. Changes have since taken place in Scottish prisons.

AIMS: To estimate the expected number of male suicides in Scottish prisons in 1994-2003, having taken age and opioid dependency into account; and to consider the extremes of prisoner age.

METHOD: The effective number that prisons safeguard in terms of suicide risk was approximated as 10 times the number of opioid-dependent inmates plus other inmates. By applying age-appropriate suicide rates for Scottish males to these effective numbers, expectations for male suicides in Scottish prisons were calculated.

RESULTS: In 1994-98, there were at least 57 male suicides, significantly exceeding the age- and opioid-adjusted expectation of 41. In 1999-2003, the 51 male suicides in prison were consistent with expectation (upper 95% limit: at least 54). During the decade 1994-2003, observed and expected suicides were mismatched at both extremes of age: 40 males aged 15-24 years died by suicide v. 24 expected, and 13 males aged 45+ v. 2 expected. Against 4.5 prison suicides expected for males aged 15-24 years during a 2-year period, actual suicides were 3 in 2002 + 2003 and 4 in 2004 + 2005.

CONCLUSIONS: Scotland has redressed an excess of male suicides, especially by its youngest prisoners.