Predictors of suicidal ideation, suicide attempts, and self-harm without lethal intent in a community corrections sample Tracy D. Gunter a,b, ⁎, John T. Chibnall a , Sandra K. Antoniak b , Robert A. Philibert b , Nancy Hollenbeck b a Saint Louis University School of Medicine, Department of Neurology & Psychiatry, United States b University of Iowa Carver College of Medicine, Department of Psychiatry, United States abstract article info Available online 21 March 2011 Purpose: Little published research data exist about suicidal ideation and self-harm behavior in community corrections and we seek to fill this void. Aims: To examine the effects of drug dependence, depression, anxiety, psychopathy, fracture, and child trauma on suicidal ideation, suicide attempts, and self-harm without lethal intent in community corrections. Methods: The Semi-Structured Assessment for the Genetics of Alcoholism Revised (SSAGA II) and the screening version of the Hare Psychopathy Checklist (PCL:SV) were administered. Separate binary logistic regression analyses were used to predict lifetime suicidal ideation, suicide attempt, and self-harm behavior. Results: Prevalences of suicidal ideation, suicide attempt, and self-harm without lethal intent were 41%, 19%, and 14%. Suicidal ideation was predicted by drug dependence, elevated PCL:SV Factor 2 score, and Caucasian race. Suicidal ideation and attempt were both predicted by fractures, depression, and child trauma. Self-harm was predicted by fractures, panic, PCL:SV score, and child trauma. Conclusions: Child trauma and multiple fractures are potent predictors for suicidal ideation, suicide attempts, and self-harm without lethal intent in this community corrections sample. Depression predicted suicidal ideation and attempts, while panic predicted self-harm without lethal intent. Psychopathy was also an important predictor of suicidal ideation and self-harm behaviors without lethal intent. © 2011 Elsevier Ltd. All rights reserved. Introduction The main objectives of the criminal justice system include deterrence, incapacitation, retribution and rehabilitation of criminal offenders (Yang, Kadouri, Revah-Levy, Mulvey, & Falissard, 2009). Yet, as government and private mental health institutions have faded from prominence, correctional facilities (i.e., jails, prisons, and community corrections) have increasingly become caregivers for people with acute and chronic mental illnesses (Suto & Arnaut, 2010; Torrey, Kennard, Elsinger, Lamb, & Pavle, 2010; Wortzel, Binswanger, Anderson, & Adler, 2009). Additional sociologic factors, such as the loss of traditional social networks and population migration, have also contributed to the increasing involvement of mentally ill individuals in the criminal justice system (Harrison & Rogers, 2007). As the responsibility of caring for those with mental illness continues to shift from medical to correctional services, one would expect the associated risks of lethal and nonlethal self-harm behaviors to rise in correctional settings (Suto & Arnaut, 2010; Wortzel et al., 2009). In fact, several researchers have noted that self-harm behaviors, attempted suicide, and suicide are higher among correctional popula- tions than in the general population (Bjork & Lindqvist, 2005; Jeglic, Vanderhoff, & Donovick, 2005; Joukamaa, 1998; Kenny, Lennings, & Munn, 2008; Paanila, Hakola, & Tiihonen,1999; Roe-Sepowitz, 2007). Given that the correctional system in the United States serves over 7.2 million offenders each year (Glaze, 2010), this population presents serious public health challenges. Although the vast majority of offenders are served in the community (5 million of the 7.2 million) (Glaze, Bonczar, & Zhang, 2010), most studies focus on self-injurious behavior, with and without suicidal intent, during incarceration. Few studies examine these behaviors in the context of community supervision of offenders (Wessely, Akhurst, Brown, & Moss, 1996) despite the previous finding that community offenders were at greater risk to die than prisoners (Pratt, Piper, Webb, & Shaw, 2006; Sattar, 2003). Suicidal behavior The correctional population is skewed toward groups demograph- ically at risk for addiction, mental illness, and healthcare disparities. Risk factors for suicide among the general population are also operant in correctional settings, including previous suicide attempt, mental health disorders (especially depressive disorders), substance abuse and Journal of Criminal Justice 39 (2011) 238–245 ⁎ Corresponding author at: Saint Louis University School of Medicine, Department of Neurology & Psychiatry, 1438 S. Grand Blvd., St. Louis, MO 63104, United States. E-mail address: tgunter2@slu.edu (T.D. Gunter). 0047-2352/$ – see front matter © 2011 Elsevier Ltd. All rights reserved. doi:10.1016/j.jcrimjus.2011.02.005 Contents lists available at ScienceDirect Journal of Criminal Justice