[Suicide prevention in Hamburg's penal system-analysis of cases from 2013-2022 and evaluation of interviews with inmates and staff].

BACKGROUND: Since 1962, suicide cases in Hamburg's penal system have been scientifically analyzed with regard to causes and risk factors in order to improve suicide prevention measures. The present study builds on this long-term research tradition and examines suicides occurring between 2013 and 2022. Additionally, interviews with inmates and staff provide insights into the challenges of suicide prevention in custody. METHODS: The study followed a mixed-methods approach. For suicide cases from 2013 to 2022, forensic autopsy reports as well as inmate personnel and health records were quantitatively and descriptively analyzed. Additionally, between September and October 2022, qualitative guideline-based interviews were conducted with staff and inmates of the pre-trial detention center regarding their experiences and approaches to suicide. The qualitative data were analyzed using content analysis based on a deductive-inductive category system. RESULTS: During the study period, 20 suicides were recorded, with the highest prevalences observed in 2017, 2020, and 2021 (four cases each). No direct link to the pandemic could be established. Twelve suicides (60%) occurred in pre-trial detention, and 18 (90%) involved men. The most common method was strangulation (18 cases, 90%). The interviews indicate potentially suicide-relevant aspects of working and detention conditions. DISCUSSION: Compared to earlier surveys, the annual number of suicides has slightly decreased. The findings indicate that suicides in the (Hamburg) penal system remain a persistent challenge. Preventive measures such as suicide screenings, psychological support, training, and further education for staff, as well as structural and architectural adjustments, may reduce risk factors for suicide.