Psikolojik A aş ı ma Pe spek i le i De gisi
Jou nal o Psychological Resea ch Pe spec i es
JOPRP 3 (1)
h ps://doi.o g/10.5281/zenodo.17506576
De leme Makale/Re iew A icle
Bu makale, a aş ı ma e yayın e iğine uygun ola ak hazı lanmış e iThen ica e ile in ihal a amasından geçi ilmiş i . The Au ho (s).
This a icle was p epa ed in line wi h esea ch and publica ion e hics and scanned o plagia ism by using iThen ica e.
Le ’s B eak he Silence: Suicide in P isons- Risk Fac o s, Epidemiology and P e en ion
Sessizliği Yıkalım: Cezae i İn iha la ı-Epidemiyoloji, Riskle e Önleme
1. Tuğba Gö gülü
1
Abs ac
Suicide in p isons is a majo public heal h and ins i u ional conce n. Inca ce a ed indi iduals ace a much highe
isk o suicide han he gene al popula ion. This e iew syn hesizes cu en li e a u e on he epidemiology,
psychosocial isk ac o s, and p e en ion o suicidal beha io among p isone s. I highligh s he in e play be ween
indi idual ulne abili ies (impo a ion model) such as psychia ic diso de s, pas auma, subs ance use, and social
disad an age and p ison-speci ic s esso s (dep i a ion model), including o e c owding, isola ion, limi ed social
con ac , and s ic disciplina y measu es. S udies show ha he ea ly pe iod o inca ce a ion, especially he i s
days and weeks, is a c i ical window o heigh ened suicide isk due o adjus men di icul ies, acu e s ess, and loss
o social suppo . E ec i e p e en ion equi es an in eg a ed app oach combining in e en ions o high- isk
indi iduals, such as men al heal h sc eening, psychosocial suppo , auma-in o med he apy, and ange
managemen , wi h b oade s a egies o imp o e p ison condi ions, enhance social connec ions, and os e a
suppo i e en i onmen . S eng hening amily ies, p omo ing posi i e s a -inma e ela ionships, and p o iding
educa ional, oca ional, and ec ea ional p og ams can u he enhance esilience and educe sel -ha m isk.
Comp ehensi e s a egies add essing bo h indi idual and en i onmen al ac o s a e essen ial o mi iga e suicide
isk. This e iew emphasizes he need o in e disciplina y, mul i-le el in e en ions o sus ainable suicide
p e en ion in co ec ional se ings.
Keywo ds: P ison Suicide, Sel -ha m, Inca ce a ed, Risk Fac o s, Suicide P e en ion.
Öze
Cezae i in iha la ı hem halk sağlığı hem de ku umsal bi so undu . Mahkumla , genel nü usa kıyasla çok daha
yüksek in iha iski al ındadı . Bu de leme, mahkumla a asında in iha da anışının epidemiyolojisi, psikososyal
isk ak ö le i e önleme s a ejile ine ilişkin güncel li e a ü ü öze lemek edi . Bi eysel so unla (i hala / aşıma
modeli); psikiya ik bozuklukla , geçmiş a mala , madde kullanımı e sosyal deza an ajla ile cezae ine özgü
s es ak ö le i (yoksunluk modeli), ö neğin aşı ı kalabalık hüc ele , izolasyon, sını lı sosyal emas e sıkı disiplin
önlemle i a asındaki e kileşim u gulanmak adı . A aş ı mala , özellikle u ukluluğun ilk günle i e ha ala ının,
uyum zo lukla ı, aku s es e sosyal des ek kaybı nedeniyle in iha iskinin en yüksek olduğu k i ik bi dönem
olduğunu gös e mek edi . E kili önleme, yüksek iskli bi eyle için men al sağlık a amala ı, psikososyal des ek,
a ma odaklı e api e ö ke kon olü gibi müdahalele le, cezae i koşulla ının iyileş i ilmesi, sosyal bağlan ıla ın
güçlendi ilmesi e des ekleyici bi o amın oluş u ulmasını bi leş i en en eg e bi yaklaşım ge ek i i . Aile
bağla ının güçlendi ilmesi, olumlu pe sonel-mahkûm ilişkile inin eş ik edilmesi e eği im, mesleki e ek ea i
p og amla ın sunulması psikolojik dayanıklılığı a ı abili e in iha ile kendine za a e me iskini azal abili .
Hem bi eysel hem de çe esel ak ö le i ele alan kapsamlı s a ejile , in iha iskini azal mak için esas ı . Bu
de leme, cezae le inde sü dü ülebili in iha önleme için disiplinle a ası e çok düzeyli müdahalele in önemini
u gulamak adı .
Anah a Kelimele : Cezae i İn iha ı, Kendine Za a Ve me, Mahkûm, Risk Fak ö le i, İn iha ı Önleme.
Baş u u/Submi ed: 04/09/2025
Kabul/Accep ed: 11/10/2025
Yayın/Online Published: 05/11/2025
A ı /Ci a ion: Gö gülü, T. (2025). Le ’s b eak he silence: Suicide in p isons- isk ac o s, epidemiology and p e en ion.
Jou nal o Psychological Resea ch Pe spec i es, 3(1), h ps://doi.o g/10.5281/zenodo.17506576
1
Doç. D . Anadolu Üni e si esi, Edebiya Fakül esi, Psikoloji Bölümü, Eskişehi , Tü kiye, ugba_go [email protected].
Le ’s B eak he Silence: Suicide in P isons- Risk Fac o s, Epidemiology and P e en ion
Suicidal beha io , de ined as an in en ional sel -di ec ed ac ha may o may no esul
in dea h, has been inc easing wo ldwide, wi h nea ly 800,000 dea hs by suicide epo ed each
yea . Epidemiological da a show ha suicide a es ha e isen by app oxima ely 30% o e he
pas wo decades, making suicide he en h leading cause o dea h ac oss all age g oups.
Suicide is he mos common cause o dea h among young people and he second leading
cause o dea h among 15-29-yea -olds, a e a ic acciden s and o he unna u al causes
(Fleischmann & De Leo, 2014; WHO, 2025). A p e ious suicide a emp is ecognized as one
o he s onges p edic o s o u u e suicidal beha io . Resea ches indica e ha a signi ican
p opo ion o indi iduals who engage in an ini ial suicide a emp a e likely o epea such
beha io wi hin he ollowing yea , wi h some s udies epo ing ecu ence a es app oaching
50% (Bos wick e al., 2016; Schmid ke e al., 1996). This highligh s he impo ance o
unde s anding suicidal beha io no me ely as an isola ed psychological c isis, bu as a
complex phenomenon eme ging om he in e ac ion o mul iple pe sonal, social, and
en i onmen al isk ac o s.
Suicide a es in p isons a e conside ably highe han in he gene al popula ion. Li e in
p isons is shaped by a ious social, psychological, and en i onmen al ac o s ha c ea e
signi ican isks o inma es’ men al heal h. Resea ches indica e ha suicide beha io among
male inma es is h ee o eigh imes highe han in gene al popula ion, while among emale
inma es i is en imes highe (Fazel e al., 2017). App oxima ely 80 % o p isone s a e
epo ed o be a signi ican isk o suicide (Gö gülü & Tu a el-Kişlak, 2014). This isk is
pa icula ly ele a ed du ing he ini ial days o inca ce a ion.
Conside ing he psychosocial isks wi hin p isons, i is es ima ed ha app oxima ely
10% o inma es engage in a leas one sel -ha ming beha io du ing hei inca ce a ion (Fa il
e al., 2022). This phenomenon can be linked o indi idual-le el psychia ic and social ac o s
such as dep ession, anxie y, subs ance use, pas auma, limi ed social suppo , and loneliness
(Angelakis e al., 2020b; Gö gülü & Tu a el-Kişlak, 2014). A he ins i u ional le el,
Gö gülü
en i onmen al condi ions including single-cell con inemen , es ic ed isi a ion
oppo uni ies, lack o meaning ul ac i i ies, and absence o p i acy also con ibu e o he
occu ence o such beha io s (Huey & McNul y, 2005; La ney & Fa ell, 2017).
The exis ing li e a u e indica es ha he phenomenon o suicide in p isons has been
p edominan ly s udied in high-income coun ies. In con as , sys ema ic and compa able da a
om low- and middle-income egions emain sca ce (Fazel e al., 2011; Mund & Baggio,
2024). This gap hinde s he de elopmen o e ec i e suicide p e en ion s a egies a bo h
na ional and global le els. E ec i e in e en ions should no be limi ed o indi idual
psychological suppo and ea men . They should also include s a aining, isk assessmen
sys ems, imp o emen s in p ison condi ions, and he s eng hening o social suppo ne wo ks.
Limi ed access o men al heal h se ices and s uc u al challenges in many coun ies,
including Tu kiye, pose addi ional obs acles o hese ini ia i es. The e o e, p e en ing suicide
in p isons should be app oached as a mul idimensional p ocess equi ing in e disciplina y
collabo a ion and comp ehensi e ins i u ional in e en ions. Wi hin his con ex , he p esen
s udy examines he de ini ion o suicidal beha io , epidemiological indings, and key suicide
isk ac o s in p isons, while o e ing ecommenda ions o e ec i e and sus ainable p ison
suicide p e en ion policies.
Suicide Risk Fac o s in P isons
P ison suicide is one o he mos signi ican men al heal h challenges aced by
co ec ional sys ems wo ldwide. In e na ional da a indica e ha he isk o suicide among
inma es is 5-10 imes highe han in he gene al popula ion (Bachmann, 2018). The ini ial
days o de en ion a e pa icula ly c i ical, ep esen ing he pe iod o he highes isk (Radelo
e al., 2021). Two main app oaches ha e been p oposed o unde s and his isk. Those a e he
Impo a ion Model and Dep i a ion Model. These models ep esen wo undamen al
heo e ical pe spec i es on he pa e ns o esponse o imp isonmen (Schwa z, 1971; Thomas
& Fos e , 1973). The Impo a ion Model ocuses on indi idual cha ac e is ics and psychia ic
ac o s om a psychological and public heal h pe spec i e, while he Dep i a ion Model
Le ’s B eak he Silence: Suicide in P isons- Risk Fac o s, Epidemiology and P e en ion
emphasizes he nega i e condi ions c ea ed by he p ison en i onmen om a sociological and
c iminological pe spec i e. The psychological pe spec i e iden i ies ac o s such as
dep ession, anxie y, subs ance use, auma his o y, and gene ic ulne abili y as key
con ibu o s o suicide isk. In con as , he sociological app oach highligh s ha inma es
o en come om disad an aged social backg ounds. Ad e se p ison condi ions, such as
o e c owded cells, social isola ion, limi ed communica ion, and s ic disciplina y measu es,
inc ease psychological p essu e and can igge suicidal beha io . The wo p incipal
heo e ical app oaches explaining suicide in p isons a e examined in he ollowing sec ions.
Impo a ion Model: Psychological and Public Heal h Pe spec i e
Wi hin he amewo k o he Impo a ion Model, inma es al eady possess ce ain isk
ac o s be o e en e ing p ison. Suicidal beha io , in his con ex , is la gely independen o he
p ison en i onmen and is p ima ily associa ed wi h p e-exis ing psychological condi ions and
social disad an ages. In o he wo ds, hese indi iduals ep esen a high- isk and socially
disad an aged popula ion. Conside ing he widesp ead p e alence o men al diso de s and
a ious psychosocial di icul ies among p isone s, he Impo a ion Model emphasizes he
impo ance o iden i ying and add essing hese ulne abili ies ea ly in he inca ce a ion
p ocess (Molina-Coloma e al., 2021). The Impo a ion Model o e s a compelling and
cohe en explana o y amewo k o unde s anding suicide in co ec ional se ings. In his
con ex , he isk ac o s emphasized by his model a e as ollows:
Suicide idea ion, sel -ha m and suicide a emp s
Among he s onges p edic o s o suicidal beha io a e suicidal idea ion, a his o y o
sel -ha m, and p e ious suicide a emp s (Liu e al., 2022). Suicidal hough s ha in ol e
planning and conc e e p epa a ions ep esen he mos c i ical isk ac o s o suicidal
beha io , pa icula ly when accompanied by eelings o hopelessness and helplessness (Baue
e al., 2022; Gö gülü, 2020). In p ison popula ions, his isk is signi ican ly highe compa ed
o he gene al popula ion. App oxima ely 33% o p isone s epo suicidal idea ion, while 9%
ha e made a leas one a emp du ing inca ce a ion. Suicide a emp a es a e 12.2% among
Gö gülü
men and 8.6% among women in p isons (Fa il e al., 2020; Fa il e al., 2022). Fu he mo e,
19-22% o inca ce a ed indi iduals ha e a emp ed suicide a some poin in hei li es which
is a high isk o suicide. The isk is pa icula ly ele a ed in he ini ial weeks o imp isonmen
due o acu e s ess and adjus men di icul ies (Radelo e al., 2021), wi h suicide a es
eaching nea ly 10 imes highe han hose o he popula ion.
Psychia ic diso de s
Psychia ic diso de s a e among he mos signi ican de e minan s o high- isk
beha io s, wi h mood diso de s ep esen ing pa icula ly s ong p edic o s. Majo dep ession
and bipola diso de a e equen ly linked o an inc eased isk o suicide, wi h app oxima ely
15% o indi iduals wi h dep ession exhibi ing ela ed high- isk beha io s, and 50-60% o
hose who died by suicide ha ing a his o y o majo dep essi e diso de (Angs e al., 1999;
Jeon, 2011). In Canadian co ec ional acili ies, he li e ime p e alence o dep ession among
p isone s anges om 21.5% o 29.8% (Boo hby & Du ham, 1999). Subs ance use diso de s
u he ampli y his isk, pa icula ly when co-occu ing wi h dep essi e symp oms. Nea ly
hal o he indi iduals who died by suicide we e epo ed o ha e a his o y o subs ance use
(Schneide , 2009). Among inma es, subs ance use is highly p e alen , wi h obacco use
epo ed in 72%, alcohol use in 26-39%, and illici d ug use in 64% o indi iduals (Bu le e
al., 2003). Bo de line Pe sonali y Diso de , cha ac e ized by emo ional dys egula ion,
impulsi i y, and ea o abandonmen , is also a signi ican isk ac o , wi h 9-33% o a ec ed
indi iduals ha ing engaged in high- isk beha io s a leas once in hei li e ime. In p ison
popula ions, he p e alence o psychia ic diso de s is ma kedly highe han in he gene al
popula ion. Condi ions such as dep ession, bipola diso de , subs ance use diso de s, and
bo de line pe sonali y diso de occu se e al imes mo e equen ly among inma es (A moon
e al., 2021; Mund & Baggio, 2024). The high p e alence o hese psychia ic and subs ance-
ela ed condi ions con ibu es subs an ially o he ele a ed incidence o high- isk beha io s
wi hin co ec ional se ings.
Le ’s B eak he Silence: Suicide in P isons- Risk Fac o s, Epidemiology and P e en ion
Neglec and abuse
A conside able p opo ion o o ende s ha e expe ienced such ad e si ies du ing
childhood and adolescence, which a e widely ecognized as majo con ibu o s o long- e m
psychosocial di icul ies (Angelakis e al., 2020b; Capuzzi e al., 2021). Empi ical e idence
consis en ly demons a es ha ea ly auma ic expe iences, pa icula ly ecu en abuse,
unde mine sel -concep and os e eelings o wo hlessness, guil , and helplessness, he eby
inc easing ulne abili y o bo h c iminal and sel -des uc i e beha io s (Angelakis e al.,
2020a; Kaplan e al., 1997). Emo ional and beha io al p oblems commonly obse ed among
auma su i o s, such as ange , impulsi i y, and agg ession, may u he acili a e c iminal
in ol emen and ele a e he isk o sel -ha m. The p ison en i onmen in ensi ies his
ulne abili y, as isola ion, puni i e condi ions, and limi ed social ies o en eac i a e ea lie
eelings o insecu i y and helplessness (A mou , 2012). Fo inma es wi hou adequa e amily
o social suppo , hese condi ions may e ode coping capaci ies and inc ease suscep ibili y o
sel -inju ious o suicidal beha io s, posi ioning childhood auma as a c i ical de e minan o
bo h o ending and suicide isk.
Physical and men al heal h p oblems
Ch onic illnesses and in ec ious diseases, such as HIV and hepa i is C, occu a a es
o 5-10% among p isone s, subs an ially highe han in he gene al popula ion (Weyan e al.,
2023). Psychia ic diso de s and subs ance use a e also widesp ead among inma es, and he
p e alence o hese p oblems is signi ican ly highe han in he gene al popula ion. The
combina ion o social disad an age and heal h p oblems makes p isone s mo e
psychologically ulne able and less able o cope wi h s ess. This unde sco es he u gen need
o comp ehensi e in e en ions a mul iple le els, including imp o emen s in educa ion,
social suppo , heal hca e access, and li ing condi ions wi hin p isons.
Social ac o s and heal h p oblems
One o he isk ac o s o he Impo a ion Model is social ac o s and heal h p oblems
among p isone s. P isons p edominan ly house socioeconomically disad an aged and
Gö gülü
ulne able indi iduals. A ound 60% o inma es ha e no comple ed high school (Ha low,
2003), while in he Uni ed Kingdom, o e 30% en e p ison li ing a o nea he po e y line,
and nea ly 20% o p isone s in se e al coun ies lack s able housing p io o inca ce a ion
(G eenbe g & Rosenheck, 2008). These nega i e ac o s ep esen key s uc u al
ulne abili ies o inma es.
Dep i a ion Model: S uc u al and Ins i u ional Risk Fac o s
The ele a ed isk o suicide among inca ce a ed indi iduals is shaped no only by p e-
exis ing psychopa hological ulne abili ies o ad e se li e expe iences p io o imp isonmen
bu also by he s uc u al and social condi ions wi hin co ec ional acili ies. Empi ical
esea ch highligh s ha suicide in p isons is a mul idimensional phenomenon, a ising om he
dynamic in e play be ween indi idual suscep ibili ies and en i onmen al s esso s inhe en in
ins i u ional con ex s (Mazhe & A ai, 2025).
The Dep i a ion Model has been widely used o explain hese ins i u ional in luences,
emphasizing ha soli a y con inemen , es ic ed social suppo , high-secu i y en i onmen s,
and he in ake p ocess signi ican ly inc ease suicide isk (Thomas, 1977). Acco ding o his
model, he loss o au onomy combined wi h dep i a ion o undamen al human needs, such as
eedom, sa e y, p i acy, and meaning ul social in e ac ion, can p oduce p o ound and
endu ing psychological consequences (Hayes, 1995). Newly admi ed inma es a e pa icula ly
ulne able, as hey a e o en sepa a ed om amily, lose p io social suppo s, and expe ience
ab up dis up ions o hei daily ou ines. These dep i a ions unde mine social iden i y,
belonging, and sel -wo h, and esea ch indica es ha such es ic ions a e s ongly associa ed
wi h heigh ened dep essi e a ec and inc eased suscep ibili y o suicidal beha io (Mille ,
1994). En i onmen al s esso s commonly obse ed in p isons, such as o e c owded cells,
excessi e noise, lack o p i acy, and limi ed physical space, u he s ain psychological
esilience and in ensi y men al heal h di icul ies. In addi ion, he absence o meaning ul
ac i i ies and es ic ed oppo uni ies o social engagemen can exace ba e eelings o
bo edom, helplessness, and despai . Ch onic s ess, adap a ion challenges, and emo ional
Le ’s B eak he Silence: Suicide in P isons- Risk Fac o s, Epidemiology and P e en ion
exhaus ion wi hin he p ison con ex a e consis en ly iden i ied as some o he mos
signi ican ins i u ional de e minan s o suicide (Huey & McNul y, 2005). High-secu i y
acili ies a e pa icula ly conce ning, as he combina ion o s ic ou ines, con inuous
su eillance, and educed au onomy ampli ies social isola ion and psychological s ain.
Mo eo e , he p ison in ake p ocess i sel cons i u es a c i ical pe iod o ulne abili y.
Du ing he ini ial days and weeks o inca ce a ion, inma es equen ly expe ience shock,
anxie y, unce ain y, and diso ien a ion (D'O a e al., 2022; Reinha d & Roge s, 1998).
These condi ions can p ecipi a e acu e psychological dis ess, especially o indi iduals wi h
p e-exis ing men al heal h issues o p io auma exposu e. Limi ed access o social suppo
du ing his pe iod can u he comp omise coping capaci y, inc easing he likelihood o sel -
ha m o suicidal beha io (Radelo e al., 2021).
P ison in ake p ocess and maladjus men
The ini ial pe iod o inca ce a ion cons i u es a c i ical high- isk phase o inma es and
is equen ly associa ed wi h ele a ed suicide isk. Newly admi ed indi iduals expe ience no
only he loss o pe sonal eedom bu also heigh ened unce ain y, ea , and anxie y ega ding
hei immedia e and u u e ci cums ances. Du ing his pe iod, in ense emo ional eac ions
such as shock, ange , helplessness, and acu e dis ess a e common and may inc ease
suscep ibili y o sel -ha ming beha io s (Hayes, 1995).
Adjus men challenges a e compounded by un amilia i y wi h ins i u ional ules,
p ocedu es, and social dynamics, as well as he need o na iga e a no el and o en s ess ul
en i onmen . These ac o s con ibu e o heigh ened psychological ulne abili y, wi h he i s
weeks o inca ce a ion ep esen ing a pa icula ly high- isk o suicide idea ion and suicidal
beha io (Radelo e al., 2021). Gi en hese isks, he implemen a ion o s uc u ed
psychosocial suppo p og ams o newly admi ed inma es is essen ial (Calea e al., 2016).
Such p og ams should p o ide o ien a ion o ins i u ional ou ines, deli e emo ional and
social suppo , and acili a e he de elopmen o adap i e coping s a egies. In e en ions may
include men o ship schemes, g oup he apy sessions, and egula psychological counseling,
Gö gülü
all designed o enhance esilience and educe ulne abili y. A obus in ake suppo
amewo k enables ea ly iden i ica ion o high- isk indi iduals, acili a es adap a ion o he
p ison en i onmen , and ensu es apid in e en ion in c isis si ua ions. Acco dingly, a ge ed
measu es du ing he in ake p ocess play a pi o al ole in mi iga ing suicide isk a bo h he
indi idual and ins i u ional le els.
Lack o social suppo and e ec o social isola ion
One o he mos c i ical p edic o s o suicidal beha io is he weakness o social
suppo mechanisms. Social suppo no only ul ills indi iduals’ emo ional needs bu also
s eng hens hei capaci y o cope wi h s ess, he eby se ing as a p o ec i e bu e agains
ad e se li e e en s (Hou e al., 2022). Wi hin p ison se ings, he weakening o ies wi h
amily membe s and social ne wo ks o en in ensi ies eelings o loneliness and helplessness.
In pa icula , inma es who lack suppo sys ems o who ha e agile amily ela ionships a e
a g ea e isk o suicide (Ma zano e al., 2016).
In co ec ional en i onmen s, social suppo ex ends beyond amily and pee
ela ionships. In e ac ions wi h p ison s a also cons i u e an essen ial componen o his
p ocess. Expe iencing accep ance and ai ea men om s a can enhance inma es’ sense o
sel -wo h. Con e sely, being subjec ed o exclusion, beli lemen , a bi a y disciplina y
p ac ices, o hos ile a i udes can os e eelings o wo hlessness and hopelessness, he eby
ele a ing suicide isk. Resea ch indica es ha suppo i e s a a i udes mi iga e loneliness,
enhance sel -es eem, and con ibu e o he de elopmen o psychological esilience among
inma es (Ma zano e al., 2016; P a & Fos e , 2020). The e o e, s eng hening social suppo
sys ems in p isons depends no only on main aining amily connec ions bu also on os e ing
mo e cons uc i e and posi i e ela ionships be ween inma es and co ec ional s a .
Ini ia i es such as encou aging amily isi s, expanding oppo uni ies o communica ion wi h
he ou side wo ld, and aining p ison s a in psychosocial suppo a e conside ed i al
p o ec i e measu es o educing suicide isk.
Le ’s B eak he Silence: Suicide in P isons- Risk Fac o s, Epidemiology and P e en ion
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