A tale of two worlds: life and death in prison. A comparison between Italy, and England and Wales

Suicide is a public health concern around the world. Undoubtably suicide is not a discrete event, and certainly it is not a pathology, and this is the only certainty that sustains the otherwise complicated spectrum of suicide. Suicide is essentially a psychological pain that becomes intolerable. The causes of suicide are not fully known but suicide behaviour is the complex outcome of a long-consuming suffering process. The aim of this paper is to direct attention to suicide in the prison environment by looking at the suicide trends in Italy, and England and Wales, countries that differ in many ways for their responses to the problem but that they share the same responsibility and duty: humanising and making prison conditions liveable. The interest is to look at vulnerability and suicidality risk of inmates and to see whether prison conditions increase the risk of suicide or could, in some situations, even accelerate and encourage suicide. The practice of assessment of dynamic (also precipitating and acute) risk factors, and of the specific needs of the prison population, should become part of a preventive practice, dedicated not only to tackle suicide but more importantly improve the health conditions of people in prison.