Rates for self-inflicted deaths (SIDs) were analysed in English and Welsh prisons. Whilst the overall reductions in SIDs are to be welcomed, the data demonstrate that there is variation in progress with SIDs reduction across the different types of prison. SIDs is increasing in High Security prisons and these findings have implications for both research and commissioning. Those that commission prison mental health services in Primary Care Trusts must recognise the need for targeted interventions that acknowledge three major issues indicated in the literature: the likely childhood trauma experienced by mentally disordered prisoners; a better recognition of the important role played by victimisation and intimidation in SIDs; and greater investment in alcohol treatment programmes in prison. Research should be commissioned that examines these factors in relation to SID
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