Conference Agenda

Introduction: Individuals in correctional facilities are at ten times greater risk of engaging in suicidal behavior than their counterparts in general population (Bukten et al., 2022; Favril et al, 2022; Fazel et al., 2016; Mundt et al., 2024). Preventive behavioral interventions have proven to be effective in reducing rates of suicide in prison settings (Carter et al., 2022). However, it remains unclear who benefits most from each type of intervention, as effects vary across subgroups of incarcerated individuals and types of prison settings. Assessing which variables drive variation in treatment effects can improve our understanding of intervention effectiveness.

Methods: Following PRISMA 2020 guidelines, 14 studies were selected from a search conducted across EBSCOHost, ScienceDirect, PubMed and ProQuest between 1990 and 2026. Using a meta-analytic approach, relevant data were extracted including bibliometric, methodological and suicide-related features, as well as individual, prison typology and contextual potential moderators.

Results: From 19,398 records, 14 studies were eligible, comprising 18,597 participants (mean age 29.74 years, SD = 7.74). Behavioral interventions evaluated in the current literature showed a significant overall size effect Hedges’ g = 0.39, CI95 = [0.00, 0.77], Z = 1.98, p < .05, in favor of suicide and self-harm reduction. High heterogeneity between the effect size estimates, I² = 74.6%, supported the moderation analysis, which revealed a significantly wider effect of the interventions on death by suicide outcome in comparison to the other outcomes, g = 1.72, p < .01; and a greater reduction with interventions delivered collectively or combining individual and group modules, g = 0.81, p < .01.

Conclusions: Behavioral interventions with specific preventive components have been proven to be effective in reducing suicide risk in prison settings. Delivering psychoeducational intervention, together with group-based modalities appear to play the most significant role in lowering this risk.

Introduction People in prison face a suicide risk five times higher than the general population, driven by individual vulnerabilities and detention-specific stressors. Multifactorial programs, including gatekeeper training and continuous risk formulation, show promise but often fail to address the unique context of detention. This study describes the adaptation and validation of three tailored suicide prevention tools: (1) an e-learning module for prison staff, (2) a guideline for discussing suicidal ideation and behaviour and formulating risk, and (3) practical advice on safety planning within detention settings.

Methods The e-learning module was evaluated in a pilot pre-post study (N = 151) measuring attitudes towards suicide and gatekeeper self-efficacy. Perceived usability was assessed at post-test. The guideline and safety planning advice were developed and refined through a co-creation process involving incarcerated individuals (N=8) and prison professionals (N=13) using semi-structured interviews of up to 60 minutes.

Results After completing the e-learning, participants showed significant improved attitudes and self-efficacy regarding suicide prevention. Participants rated the module as relevant and applicable to daily practice. The co-creation process generated concrete, context-specific recommendations for initiating conversations about suicide ideation and behaviour, documenting and updating risk formulations, and safety planning, ensuring alignment with the realities of detention settings.

Conclusion Tailored interventions can effectively integrate suicide prevention into the challenging prison environment. Adapting tools to the specific needs and context of detention is essential for improving feasibility and impact. These findings underscore the importance of participatory approaches in developing effective suicide prevention strategies for high-risk settings.

Correctional work is widely recognized as one of the most stressful and demanding occupational environments. Among numerous stressors, exposure to suicidal and self-harming behavior is particularly concerning. Such exposure is expected to have both short- and long-term consequences for prison staff; however, most existing studies are qualitative in nature (Fontao et al., 2024). This quantitative study aims to evaluate the relationships between exposure to suicidal and self-harming behavior and indicators of prison staff’s psychological functioning.

A convenience sample of 252 prison staff members who directly interact with inmates across all Lithuanian prisons participated. Respondents completed anonymous questionnaires in their work environment. The sample consisted of 85 men and 163 women, with a mean age of 41.5 years (SD = 9.98). Within the past year, 132 participants reported at least one suicide in their prison, 153 reported suicide attempts, and 209 reported incidents of self-harm. Measures included well-being, stress, depression, anxiety, coping strategies, work engagement, burnout, and related constructs.

Self-harm was identified as the most impactful event (21% of staff), followed by suicide (15.9%) and suicide attempts (7.9%). One-way ANOVA revealed significantly higher levels of depression, stress, and exhaustion among staff who witnessed suicidal behavior compared to those who had not, with effect sizes ranging from medium to large (up to η² = .17). Distress attributed to suicidal or self-harm events, measured by IES-R, was associated with other mental health indicators and explained up to 13% of variance in anxiety.

While prison work involves numerous stressors, exposure to suicidal or self-harming behavior represents an important risk factor for staff well-being. Recognizing the impact of these potentially traumatic experiences is essential for developing targeted interventions to support mental health and resilience among correctional personnel.

The study is funded by the Research Council of Lithuania (P-MIP-24-240).

Introduction: Exposure to suicidal behaviour is associated with adverse mental health outcomes, including post-traumatic stress symptoms and maladaptive coping strategies (Brough et al., 2022), as well as increased levels of depression and anxiety (Hales et al., 2014). Incarceration itself also significantly increases the likelihood of encountering others’ suicidal behaviour. This is particularly important in Lithuanian prisons, where incarcerated individuals reside in community-based facilities. However, there has been limited research focusing on the effects of such exposure on offenders' mental health. Therefore, the present study seeks to examine offenders’s mental health following direct exposure to the suicidal behaviour of others in prison settings.

Methods: A non-probability quota sample of 449 adult incarcerated individuals (age 18-82 years, M=38.62 SD=11.13, 91.1% male), stratified by type of imprisonment and detention, was recruited, representing approximately 10% of the incarcerated population in Lithuania. Participants completed self-report measures assessing exposure to suicidal behaviour and mental health outcomes, including psychological well-being, stress, depression, anxiety, post-traumatic stress symptoms, coping, and suicidality. Independent-samples t-tests were conducted to compare group means, and binary logistic regression analyses were conducted to identify psychological variables differentiating participants exposed versus not exposed to suicidal behaviour.

Results: The main results showed that participants exposed to suicidal behaviour (n=294, 65.5%) had significantly poorer psychological well-being and coping, as well as significantly higher levels of stress, depression, anxiety, post-traumatic stress symptoms, and suicidality compared with non-exposed participants (all p<.05; Cohen’s d=0.27–0.54). Higher levels/scores of stress (OR=3.30, 95% CI [1.17, 9.33], p=.02) and depression (OR=0.32, 95% CI [0.12, 0.89], p=.03) were associated with increased odds of exposure to suicidal behaviour.

Conclusions: The results of the study indicate that exposure to suicidal behaviour is associated with poorer mental health outcomes among incarcerated individuals. Accordingly, potential improvements to the prison system are suggested to enhance suicide postvention efforts.

People on probation experience an elevated risk of suicide, yet evidence on effective prevention within community justice settings remains sparse. Suicide prevention strategies often fail to account for the intersecting health, social and structural disadvantages experienced by this group. This study presents findings from a realist review exploring how, why, and in what contexts suicide prevention approaches work (or fail) for people on probation, drawing on evidence from the probation setting alongside individuals experiencing homelessness and accessing substance use services. Using realist methods, 22 papers were analysed to develop and refine programme theories explaining the mechanisms that enable or inhibit suicide prevention. Three meta‑themes were generated. The first, an integrated and targeted system wide service offer is essential. Services fragmented by narrow eligibility criteria and disjointed referral pathways create exclusion, discourage help‑seeking and can exacerbate crisis. In contrast, multi‑disciplinary, evidence led service models that address co‑occurring needs, including psychological support alongside substance use, and housing and financial instability enables earlier identification and timely intervention. Second, skilled and supported staff are critical. Many probation practitioners feel ill-equipped to identify suicide risk, particularly ideation. Access to specialist advice, comprehensive screening tools, and context‑specific suicide prevention training enhances staff confidence, accuracy of assessment, and the capacity to intervene early. Third, a person‑centred, trauma‑informed approach strengthens engagement. Trust, relational continuity and shared decision‑making increase disclosure of suicidal thoughts, promote agency, and reduce psychological distress. These relational mechanisms are protective, yet are often constrained by system pressures, high caseloads, and inconsistent supervision arrangements. The refined programme theory demonstrates that effective suicide prevention in probation requires a whole‑system response: integrated services, skilled and supported practitioners, and relationally grounded practice. Rethinking suicide prevention through a realist, system‑lens highlights not only what needs to change, but how change can generate meaningful safety and support for people on probation.