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Abstract
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Suicide is one of the leading causes of preventable deaths and remains a global public health issue. Effective suicide prevention is crucial for the reduction in suicide mortality and involves targeting interventions for groups at the greatest risk.
People on probation comprise the largest group within the criminal justice system with more than 230 0003 people currently under community supervision in England and Wales. They are hard to reach, stigmatised and socially disadvantaged, and have increased rates of premature mortality. The number of deaths by suicide of people on probation has been increasing in recent years, with 409 self-inflicted deaths recorded in 2020-21 in England and Wales, an increase of 18% from 2019 to 2020. However, people on probation are too often overlooked in terms of research and suicide prevention strategies, compared with the prison population.
People on probation have multiple and complex health needs and often lead chaotic and transient lifestyles, with limited access to and engagement with primary care and health services. This pressing public health issue requires a broader approach to improve health outcomes for a group of people who are vulnerable to falling through the health and justice service gaps.
A 2019 policy decision in England and Wales to reform the probation service might provide an opportunity to enhance a public health approach to mental health care and suicide prevention strategies focusing on early identification of risk and multiagency collaboration. This reform includes reunifying probation to a national service privatised in 2014, "seeking to improve its understanding of and influence in, the health landscape in order to improve pathways into local health services".
However, restructuring organisations is not without challenge. Health services in the UK have endured numerous restructures implemented at pace, with little evidence of benefits or improved outcomes for patients. There are lessons to be learned from these health reforms including prioritising interagency partnerships and ensuring that service design is evidence-informed and targets specific at-risk populations.
Language: en |