{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:45:41Z","timestamp":1787021141249,"version":"build-2736575974"},"reference-count":49,"publisher":"Royal College of Psychiatrists","issue":"1","license":[{"start":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T00:00:00Z","timestamp":1765497600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["BJPsych open"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec id=\"S2056472425108983_as1\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Self-harm among UK prisoners has risen over the past decade.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472425108983_as2\">\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To explore self-harm risk factors and mental health conditions in prisoners, pre- and during imprisonment, compared with the general population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472425108983_as3\">\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>This retrospective cohort study linked electronic health records and Ministry of Justice data for Welsh male prisoners (2019), and a comparison general population cohort. We examined imprisonment likelihood based on prior self-harm and mental health conditions using logistic regression. We also studied self-harm risk up to three years during imprisonment through Generalised Estimating Equations and time-stratified Cox regression, using a pre-imprisonment comparator (3 years before).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472425108983_as4\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Prisoners (\n                      <jats:italic>N<\/jats:italic>\n                      = 6095) had higher rates of self-harm and mental health conditions pre-imprisonment compared with non-prisoners (e.g. self-harm odds ratio: 2.1 (1.9, 2.2)). Self-harm risk was 5.25\u20136.47 times higher in prisoners than non-prisoners, both pre- and during imprisonment. Risk was highest shortly after incarceration, then declined, becoming lower than pre-imprisonment after 7 months. While most conditions correlated with higher self-harm risk during imprisonment (e.g. drug use, hazard ratios: 1.5\u20133.0), some (e.g. depression and alcohol use) showed weaker links in prisoners than non-prisoners, particularly from 7 months after imprisonment. Self-harm risk was seemingly higher in prisoners on remand compared with those sentenced.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472425108983_as5\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Pre-imprisonment, self-harm in male prisoners is already high compared with the general population, potentially driving a saturation effect, where known general population risk factors have a weaker effect in prisoners. Self-harm prevention should target people in contact with criminal justice, irrespective of imprisonment. In prisons, prevention efforts deployed at inception should target those with prior self-harm, drug use, learning difficulties, bipolar disorder and those on remand.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1192\/bjo.2025.10898","type":"journal-article","created":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T05:02:37Z","timestamp":1765515757000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":1,"title":["Self-harm before and during imprisonment: cohort study of males in prison linking population-based routinely collected data in Wales"],"prefix":"10.1192","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1502-389X","authenticated-orcid":false,"given":"Marcos","family":"DelPozo-Banos","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/053fq8t95","id-type":"ROR","asserted-by":"publisher"}],"name":"Swansea University"},{"name":"National Centre for Suicide Prevention and Self-Harm 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