Self-Harm and Suicidal Behavior Among Prisoners in South Asia: A Narrative Review

Abstract

Background and Aims: Self-harm and suicidal behavior in prison is a blind spot in South Asia. Little has been known about the estimates and associated factors in the countries. This narrative review discusses self-harm and suicidal behavior among the eight South Asian countries based on available studies and reports. Methods: We searched PubMed, Scopus, Google Scholar, and Google to identify the available evidence. We reviewed the articles and summarized the findings narratively. Results: Among the eight countries, only India publishes national data on prison suicide with a rate of 23·6 (2015–19) per 100,000 population, no report was found for Afghanistan, Bangladesh, Bhutan, and the Maldives. Studies conducted among prisoners in Nepal predominantly targeted psychiatric disorders like depression revealing the prevalence of suicidal thoughts at 2.3–13% and attempts at 0.9–7.2% respectively. Reports on self-harm among adult prisoners, suicidal ideation, and attempts among juvenile delinquents are available in Pakistan. However, studies revealing the rates of suicidal behavior among adult prisoners are yet to come out. The rates of suicide, suicidal thoughts, plans, and attempts among prisoners are not known in the country. Self-harm behaviors among juvenile offenders have been studied in Sri Lanka. Conclusion: Self-harm and suicidal behavior have been poorly studied in South Asia. Policy-level attention is warranted to measure the burden and prevent self-harm, and suicidal behavior among prisoners in South Asia.