Self-harm following release from incarceration: Patterns and measurement issues

Abstract

Introduction
Despite an elevated prevalence of self-harm in the incarcerated adult population, little is known about patterns of self-harm following release from prison.

Objectives and Approach
Baseline self-report interviews with 1315 adults immediately prior to release from prison in Queensland, Australia, combined with interrogation of linked health data from >3750 post-release emergency department presentations, >2000 ambulance attendances, and corrections data during periods of re-incarceration.

Results
Approximately 5% of all contacts with medical emergency services following release from prison resulted from self-harm. These were associated with being Indigenous, having a lifetime history of a mental disorder and having been identified by prison staff as being at risk of self-harm. Agreement between self-reported self-harm and medically-verified episodes of self-harm was poor.

Conclusion/Implications
Emergency services contacts resulting from self-harm following release from prison are common and represent an opportunity for tertiary intervention for self-harm. Our findings suggest that a self-reported history of self-harm should not be considered a reliable indicator of prior self-harm, or of future self-harm risk, in incarcerated adults.

Introduction

Modelling the daily exposure environment provides evidence for policy and practice. However, the dose-response relationship between exposure to food environments and obesity has not been widely investigated. This study investigated whether increased retail food environment (RFE) exposure in children was associated with a larger body mass index (BMI).

Objectives and Approach

Individually tailored environmental exposures were calculated in a GIS for home and school locations, and modelled walking routes to and from school. Exposures were linked to individual level health data in the SAIL databank for a cohort of individuals aged 11-13 years from south Wales who had BMI measurements. A fully adjusted multilevel regression model was fitted to investigate the association of RFE exposure with BMI. Based on the distance individuals lived from school, we investigated differences between children who have the potential to walk to school (“walkers” lived 4.8km).

Results

Home exposure and exposure along the walk to school was significantly greater for children living in deprived catchments, compared with children living in affluent school catchments (t = -5.25, p

Conclusion/Implications

Increased BMI was associated with greater RFE exposure along the walk home from school. The findings suggest that the walk home from school should be the focus for developing interventions and policies to discourage unhealthy eating. Research should be undertaken to better understand child purchasing habits.