Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on sleep in brain health

LIVE: Thursday 2nd May 2024, 18:00-19:30 (CEST)

Quality sleep is essential for health. But what happens to our brains when sleep patterns are disturbed? Join our experts to explore the interplay between sleep disruption and neurological diseases, and the questions that you need to be asking your patients to help you prevent the harmful effects of sleep deprivation.
ADVANCED SEARCH
Log in
Top
Social Psychiatry and Psychiatric Epidemiology
Published in: Social Psychiatry and Psychiatric Epidemiology 10/2017

01-10-2017 | Original Paper

Ambulance attendances resulting from self-harm after release from prison: a prospective data linkage study

Authors: Rohan Borschmann, Jesse T. Young, Paul Moran, Matthew J. Spittal, Ed Heffernan, Katherine Mok, Stuart A. Kinner

Published in: Social Psychiatry and Psychiatric Epidemiology | Issue 10/2017

Login to get access

Abstract

Objective

Incarcerated adults are at high risk of self-harm and suicide and remain so after release into the community. The aims of this study were to estimate the number of ambulance attendances due to self-harm in adults following release from prison, and to identify factors predictive of such attendances.

Methods

Baseline surveys with 1309 adults within 6 weeks of expected release from prison between 2008 and 2010 were linked prospectively with state-wide correctional, ambulance, emergency department, hospital and death records in Queensland, Australia. Associations between baseline demographic, criminal justice and mental health-related factors, and subsequent ambulance attendances resulting from self-harm, were investigated using negative binomial regression.

Results

During 4691 person-years of follow-up (median 3.86 years per participant), there were 2892 ambulance attendances in the community, of which 120 (3.9%) were due to self-harm. In multivariable analyses, being Indigenous [incidence rate ratio (IRR): 2.10 (95% CI 1.14–3.86)], having previously been hospitalised for psychiatric treatment [IRR: 2.65 (95% CI 1.44–4.87)], being identified by prison staff as being at risk of self-harm whilst incarcerated [IRR: 2.12 (95% CI 1.11–4.06)] and having a prior ambulance attendance due to self-harm [IRR: 3.16 (95% CI 1.31–7.61)] were associated with self-harm attendances.

Conclusions

Ambulance attendances resulting from self-harm following release from prison are common and represent an opportunity for tertiary intervention for self-harm. The high prevalence of such attendances, in conjunction with the strong association with prior psychiatric problems, reinforces the importance of providing appropriate ambulance staff training in the assessment and management of self-harm, and mental health problems more broadly, in this vulnerable population.
Literature
1.
Hawton K, Linsell L, Adeniji T, Sariaslan A, Fazel S (2014) Self-harm in prisons in England and Wales: an epidemiological study of prevalence, risk factors, clustering, and subsequent suicide. Lancet 383(9923):1147–1154CrossRefPubMedPubMedCentral
2.
Fazel S, Grann M, Kling B, Hawton K (2011) Prison suicide in 12 countries: an ecological study of 861 suicides during 2003–2007. Soc Psychiatry Psychiatr Epidemiol 46:191–195CrossRefPubMed
3.
Fazel S, Benning R, Danesh J (2005) Suicides in male prisoners in England and Wales, 1978–2003. Lancet 366(9493):1301–1302CrossRefPubMed
4.
Binswanger IA, Stern MF, Deyo RA, Heagerty PJ, Cheadle A, Elmore JG et al (2007) Release from prison—a high risk of death for former inmates. N Engl J Med 356(2):157–165CrossRefPubMedPubMedCentral
5.
Spittal MJ, Forsyth S, Pirkis J, Alati R, Kinner SA (2014) Suicide in adults released from prison in Queensland, Australia: a cohort study. J Epidemiol Community Health 68(10):993–998CrossRefPubMed
6.
Haglund A, Tidemalm D, Jokinen J, Långström N, Lichtenstein P, Fazel S et al (2014) Suicide after release from prison: a population-based cohort study from Sweden. J Clin Psychiatry 75(10):1047CrossRefPubMedPubMedCentral
7.
Pratt D, Piper M, Appleby L, Webb R, Shaw J (2006) Suicide in recently released prisoners: a population-based cohort study. Lancet 368(9530):119–123CrossRefPubMed
8.
Kariminia A, Law MG, Butler TG, Levy MH, Corben SP, Kaldor JM et al (2007) Suicide risk among recently released prisoners in New South Wales, Australia. Med J Aust 187(7):387PubMed
9.
Hawton K, Zahl D, Weatherall R (2003) Suicide following deliberate self harm: long term follow up of patients who presented to a general hospital. Br J Psychiatry 182:537–542CrossRefPubMed
10.
Owens D, Horrocks J, House A (2002) Fatal and non-fatal repetition of self-harm. Systematic review. Br J Psychiatry 181:193–199CrossRefPubMed
11.
12.
NICE (2011) Self-harm: longer-term management. National Clinical Guideline 133. National Institute for Health and Clinical Excellence, London
13.
Lloyd B, Gao CX, Heilbronn C, Lubman DI (2015) Self-harm and mental health-related ambulance attendances in Australia: 2013 data. Turning Point, Fitzroy
14.
Sterud T, Ekeberg Ø, Hem E (2006) Health status in the ambulance services: a systematic review. BMC Health Serv Res 6(1):1CrossRef
15.
Druss BG, Silke A, Compton MT, Rask KJ, Zhao L, Parker RM (2010) A randomized trial of medical care management for community mental health settings: the Primary Care Access, Referral, and Evaluation (PCARE) study. Am J Psychiatry 167(2):151–159CrossRefPubMed
16.
Rees N, Rapport F, Thomas G, John A, Snooks H (2014) Perceptions of paramedic and emergency care workers of those who self harm: a systematic review of the quantitative literature. J Psychosom Res 77(6):449–456CrossRefPubMed
17.
Rees N, Rapport F, Snooks H (2015) Perceptions of paramedics and emergency staff about the care they provide to people who self-harm: constructivist metasynthesis of the qualitative literature. J Psychosom Res 78(6):529–535CrossRefPubMed
18.
Williams B, Boyle M, Fielder C (2015) Empathetic attitudes of undergraduate paramedic and nursing students towards four medical conditions: a three-year longitudinal study. Nurse Educ Today 35(2):e14–e18CrossRefPubMed
19.
Snooks H, Evans A, Wells B, Peconi J, Thomas M (2012) What are the highest priorities for research in pre-hospital care? Results of a review and Delphi consultation exercise. Australas J Paramed 6(4):2–4
20.
Emond K, Furness S, Deacon-Crouch M (2015) Undergraduate paramedic students’ perception of mental health using a pre and post questionnaire. Australas J Paramed 12(5):1–5
21.
Lloyd B, Gao C, Heilbronn C, Lubman D (2015) Self-harm and mental health-related ambulance attendances in Australia: 2013 data. Turning Point, Fitzroy
22.
Borschmann R, Thomas E, Moran P, Carroll M, Heffernan E, Spittal MJ et al (2016) Self-harm following release from prison: a prospective data linkage study. Aust N Z J Psychiatry. 51(3):1–10. doi:10.​1177/​0004867416640090​
23.
Kinner SA, Lennox N, Williams GM, Carroll M, Quinn B, Boyle FM et al (2013) Randomised controlled trial of a service brokerage intervention for ex-prisoners in Australia. Contemp Clin Trials 36(1):198–206CrossRefPubMed
24.
Holman CAJ, Bass AJ, Rouse IL, Hobbs MS (1999) Population-based linkage of health records in Western Australia: development of a health services research linked database. Aust N Z J Public Health 23(5):453–459CrossRefPubMed
25.
Moran P, Coffey C, Romaniuk H, Olsson C, Borschmann R, Carlin JB et al (2012) The natural history of self-harm during adolescence and young adulthood: population-based cohort study. Lancet 379(9812):236–243CrossRefPubMed
26.
OESR (2008) Australian standard offence classification (Queensland extension). Brisbane, Australia: Office of Economic and Statistical Research, Queensland Government
27.
ABS (2008) National Health Survey: summary of results, 2007–2008. Australian Bureau of Statistics
28.
Madge N, Hewitt A, Hawton K, De Wilde EJ, Corcoran P, Fekete S et al (2008) Deliberate self-harm within an international community sample of young people: comparative findings from the Child & Adolescent Self-harm in Europe (CASE) Study. J Child Psychol Psychiatry 49(6):667–677CrossRefPubMed
29.
Teasdale G, Jennett B (1974) Assessment of coma and impaired consciousness: a practical scale. Lancet 304(7872):81–84CrossRef
30.
Lawless JF (1987) Negative binomial and mixed Poisson regression. Can J Stat 15(3):209–225CrossRef
31.
Stata (2013) Stata Release 13.0. Stata Corporation. 13.0 ed. Texas, USA
32.
33.
Andrews JY, Kinner SA (2012) Understanding drug-related mortality in released prisoners: a review of national coronial records. BMC Public Health 12(1):270CrossRefPubMedPubMedCentral
34.
35.
Sinclair J, Green J (2005) Understanding resolution of deliberate self harm: qualitative interview study of patients’ experiences. BMJ 330(7500):1112CrossRefPubMedPubMedCentral
36.
Avery A, Kinner SA (2015) A robust estimate of the number and characteristics of persons released from prison in Australia. Aust N Z J Public Health 39(4):315–318CrossRefPubMed
37.
Platt S, Hawton K, Kreitman N, Fagg J, Foster J (1988) Recent clinical and epidemiological trends in parasuicide in Edinburgh and Oxford: a tale of two cities. Psychol Med 18:405–418CrossRefPubMed
38.
Guthrie E, Kapur N, Mackway-Jones K, Chew-Graham C, Moorey J, Mendel E et al (2001) Randomised controlled trial of a brief psychological intervention after deliberate self poisoning. BMJ 323:165–169CrossRef
39.
Milloy M-JS, Buxton J, Wood E, Li K, Montaner JSG, Kerr T (2009) Elevated HIV risk behaviour among recently incarcerated injection drug users in a Canadian setting: a longitudinal analysis. BMC Public Health 9(1):156CrossRefPubMedPubMedCentral
40.
Fazel S, Danesh J (2002) Serious mental disorder in 23 000 prisoners: a systematic review of 62 surveys. Lancet 359(9306):545–550CrossRefPubMed
41.
Cutcher Z, Degenhardt L, Alati R, Kinner SA (2014) Poor health and social outcomes for ex-prisoners with a history of mental disorder: a longitudinal study. Aust N Z J Public Health 38(5):424–429CrossRefPubMed
42.
Kouyoumdjian FG, McIsaac KE, Liauw J, Green S, Karachiwalla F, Siu W et al (2015) A systematic review of randomized controlled trials of interventions to improve the health of persons during imprisonment and in the year after release. Am J Public Health 105(4):e13–e33CrossRefPubMedPubMedCentral
43.
Kinner S, Burford B, van Dooren K, Gill C, Gallagher C (2013) Service brokerage interventions to improve health outcomes in ex-prisoners (protocol). Cochrane Database Syst Rev 36(1):198–206
44.
Wakeman SE, Bowman SE, McKenzie M, Jeronimo A, Rich JD (2009) Preventing death among the recently incarcerated: an argument for naloxone prescription before release. J Addict Dis 28(2):124–129CrossRefPubMedPubMedCentral
45.
Lenton S, Dietze P, Olsen A, Wiggins N, McDonald D, Fowlie C (2015) Working together: expanding the availability of naloxone for peer administration to prevent opioid overdose deaths in the Australian Capital Territory and beyond. Drug Alcohol Rev 34(4):404–411CrossRefPubMed
46.
Strang J, Bird SM, Parmar MK (2013) Take-home emergency naloxone to prevent heroin overdose deaths after prison release: rationale and practicalities for the N-ALIVE randomized trial. J Urban Health. 90(5):983–996CrossRefPubMedPubMedCentral
47.
Winter R, Stoove M, Degenhardt L, Hellard M, Spelman T, Jenkinson R et al (2015) Incidence and predictors of non-fatal drug overdose after release from prison among people who inject drugs in Queensland, Australia. Drug Alcohol Depend 153:43–49CrossRefPubMed
48.
Dietze P, Jolley MD, Cvetkovski MS (2003) Patterns and characteristics of ambulance attendance at heroin overdose at a local-area level in Melbourne, Australia: implications for service provision. J Urban Health 80(2):248–260CrossRefPubMedPubMedCentral
49.
Kelly A-M, Kerr D, Dietze P, Patrick I, Walker T, Koutsogiannis Z (2005) Randomised trial of intranasal versus intramuscular naloxone in prehospital treatment for suspected opioid overdose. Med J Aust 182(1):24–27PubMed
50.
Kinner SA, Milloy M, Wood E, Qi J, Zhang R, Kerr T (2012) Incidence and risk factors for non-fatal overdose among a cohort of recently incarcerated illicit drug users. Addict Behav 37(6):691–696CrossRefPubMedPubMedCentral
51.
Spilsbury K, Rosman D, Alan J, Boyd JH, Ferrante AM, Semmens JB (2015) Cross-border hospital use: analysis using data linkage across four Australian states. Med J Aust 202(11):582–585CrossRefPubMed
52.
Nada-Raja S, Morrison D, Skegg K (2003) A population-based study of help-seeking for self-harm in young adults. Aust N Z J Psychiatry 37:600–605CrossRefPubMed
Metadata
Title
Ambulance attendances resulting from self-harm after release from prison: a prospective data linkage study
Authors
Rohan Borschmann
Jesse T. Young
Paul Moran
Matthew J. Spittal
Ed Heffernan
Katherine Mok
Stuart A. Kinner
Publication date
01-10-2017
Publisher
Springer Berlin Heidelberg
Published in
Social Psychiatry and Psychiatric Epidemiology / Issue 10/2017
Print ISSN: 0933-7954
Electronic ISSN: 1433-9285
DOI
https://doi.org/10.1007/s00127-017-1383-z

Other articles of this Issue 10/2017

Social Psychiatry and Psychiatric Epidemiology 10/2017 Go to the issue

Original Paper

The role of socio-economic status and neighborhood social capital on loneliness among older adults: evidence from the Sant Boi Aging Study

Review

Prognostic factors for return to work of employees with common mental disorders: a meta-analysis of cohort studies

Original Paper

Social identity continuity and mental health among Syrian refugees in Turkey

Erratum

Erratum to: Incidence of schizophrenia among migrants in the Netherlands: a direct comparison of first contact and longitudinal register approaches

Original Paper

Long-term effects of mental disorders on marital outcomes in the National Comorbidity Survey ten-year follow-up

Brief report

Immigrants from Mexico experience serious behavioral and psychiatric problems at far lower rates than US-born Americans