Abstract：
OBJECTIVE: High rates of suicide and self-harm are reported in prisons in Western countries, while fewer studies exist from a non-Western context. This study aims to identify rates of suicide, non-fatal suicide attempts and self-harm in Moroccan prisons and to better understand the context, methods, tools, predictors and profile of persons engaged in the acts.
METHODS: The authors report findings from a mixed-methods study carried out before an intervention project. The study consists of a systematic literature review, an analysis of suicide case files, a quantitative survey on suicide attempts and self-harm, as well as interviews and focus group discussions. The authors calculate suicide, suicide attempt and self-harm rates and present descriptive data on the incidents. The authors use regression models to explore the association between the number of incidents per individual and selected predictors, adjusting for clustering by institution.
RESULTS: Over a four-year period, 29 detained persons in Morocco died by suicide (average annual suicide rate 8.7 per 100,000). Most were men under the age of 30. Hanging accounted for all but one case. In one year, 230 suicide attempts were reported. Over a three-months period, 110 self-harm cases were reported from 18 institutions, cutting being the most common method. Self-harm was significantly more prevalent among persons with a life sentence or repeated incarcerations.
CONCLUSIONS: To make the study manageable as part of an intervention project, the authors collected data on suicides and suicide attempts from all prisons, while data on self-harm were collected from fewer prisons and over a shorter time period. The authors did not collect comparable information from detained persons who did not die by suicide, attempt suicide or self-harm. This prevented comparative analyses. Further, it is possible that self-harm cases were not reported if they did not result in serious physical injury. Data were collected by prison staff; thus, the voice of incarcerated persons is absent.
CONCLUSIONS: This study provided a solid basis for designing an intervention project including the development of a national prison policy and guidelines on suicides, suicide attempts and self-harm and a country-wide training program for prison staff. It also led to a better surveillance system, allowing for trend analysis and better-informed policymaking. The qualitative results helped create an understanding of how staff may trivialize self-harm. This was integrated into the training package for staff, resulting in the creation of prison staff trainers who became the strongest advocates against the notion that self-harm was best ignored.
CONCLUSIONS: To the best of the authors\' knowledge, this is the first published data on suicide and self-harm in Moroccan prisons. It underscores the necessity for the intervention project and gives valuable insights into suicide and self-harm in a non-Western prison context. Further research is needed to assess whether the findings are typical of the region.
METHODS: The authors report findings from a mixed-methods study carried out before an intervention project. The study consists of a systematic literature review, an analysis of suicide case files, a quantitative survey on suicide attempts and self-harm, as well as interviews and focus group discussions. The authors calculate suicide, suicide attempt and self-harm rates and present descriptive data on the incidents. The authors use regression models to explore the association between the number of incidents per individual and selected predictors, adjusting for clustering by institution.
RESULTS: Over a four-year period, 29 detained persons in Morocco died by suicide (average annual suicide rate 8.7 per 100,000). Most were men under the age of 30. Hanging accounted for all but one case. In one year, 230 suicide attempts were reported. Over a three-months period, 110 self-harm cases were reported from 18 institutions, cutting being the most common method. Self-harm was significantly more prevalent among persons with a life sentence or repeated incarcerations.
CONCLUSIONS: To make the study manageable as part of an intervention project, the authors collected data on suicides and suicide attempts from all prisons, while data on self-harm were collected from fewer prisons and over a shorter time period. The authors did not collect comparable information from detained persons who did not die by suicide, attempt suicide or self-harm. This prevented comparative analyses. Further, it is possible that self-harm cases were not reported if they did not result in serious physical injury. Data were collected by prison staff; thus, the voice of incarcerated persons is absent.
CONCLUSIONS: This study provided a solid basis for designing an intervention project including the development of a national prison policy and guidelines on suicides, suicide attempts and self-harm and a country-wide training program for prison staff. It also led to a better surveillance system, allowing for trend analysis and better-informed policymaking. The qualitative results helped create an understanding of how staff may trivialize self-harm. This was integrated into the training package for staff, resulting in the creation of prison staff trainers who became the strongest advocates against the notion that self-harm was best ignored.
CONCLUSIONS: To the best of the authors\' knowledge, this is the first published data on suicide and self-harm in Moroccan prisons. It underscores the necessity for the intervention project and gives valuable insights into suicide and self-harm in a non-Western prison context. Further research is needed to assess whether the findings are typical of the region.
摘要：
目的：据报道，西方国家的监狱中自杀和自残率很高，而来自非西方背景的研究较少。这项研究旨在确定自杀率，摩洛哥监狱中的非致命自杀企图和自我伤害，并更好地了解背景，方法,工具,参与行为的人的预测因素和概况。
方法：作者报告了在干预项目之前进行的混合方法研究的结果。本研究包括系统的文献综述，对自杀案卷的分析,关于自杀企图和自我伤害的定量调查，以及访谈和焦点小组讨论。作者计算自杀，自杀未遂和自我伤害率，并提供有关事件的描述性数据。作者使用回归模型来探索每个个体的事件数量与选定的预测因子之间的关联，按机构进行集群调整。
结果：在四年的时间里，摩洛哥有29名被拘留者死于自杀（平均每年自杀率为8.7/10万）。大多数是30岁以下的男性。除了一个案子，绞刑占了全部。一年之内,报告了230起自杀未遂事件。在三个月的时间里，18个机构报告了110起自残案件，切割是最常见的方法。在被判无期徒刑或多次监禁的人中，自残更为普遍。
结论：为了使研究成为干预项目的一部分，作者从所有监狱收集了自杀和自杀企图的数据，而关于自我伤害的数据是从较少的监狱和较短的时间内收集的。提交人没有从没有自杀死亡的被拘留者那里收集可比信息，试图自杀或自我伤害。这妨碍了比较分析。Further,如果自我伤害案件没有造成严重的身体伤害，则可能没有报告。数据是由监狱工作人员收集的；因此，被监禁者的声音不存在。
结论：这项研究为设计干预项目提供了坚实的基础，包括制定国家监狱政策和自杀指南，自杀未遂和自残以及针对监狱工作人员的全国性培训计划。这也导致了更好的监控系统，允许趋势分析和更明智的决策。定性结果有助于了解员工如何轻视自我伤害。这已被纳入员工培训计划，导致监狱工作人员培训师的产生，他们成为最强烈的倡导者，反对自残最好被忽视的观念。
结论：据作者所知，这是摩洛哥监狱中首次公布的自杀和自残的数据。它强调了干预项目的必要性，并为非西方监狱背景下的自杀和自残提供了宝贵的见解。需要进一步的研究来评估这些发现是否是该地区的典型。
方法：作者报告了在干预项目之前进行的混合方法研究的结果。本研究包括系统的文献综述，对自杀案卷的分析,关于自杀企图和自我伤害的定量调查，以及访谈和焦点小组讨论。作者计算自杀，自杀未遂和自我伤害率，并提供有关事件的描述性数据。作者使用回归模型来探索每个个体的事件数量与选定的预测因子之间的关联，按机构进行集群调整。
结果：在四年的时间里，摩洛哥有29名被拘留者死于自杀（平均每年自杀率为8.7/10万）。大多数是30岁以下的男性。除了一个案子，绞刑占了全部。一年之内,报告了230起自杀未遂事件。在三个月的时间里，18个机构报告了110起自残案件，切割是最常见的方法。在被判无期徒刑或多次监禁的人中，自残更为普遍。
结论：为了使研究成为干预项目的一部分，作者从所有监狱收集了自杀和自杀企图的数据，而关于自我伤害的数据是从较少的监狱和较短的时间内收集的。提交人没有从没有自杀死亡的被拘留者那里收集可比信息，试图自杀或自我伤害。这妨碍了比较分析。Further,如果自我伤害案件没有造成严重的身体伤害，则可能没有报告。数据是由监狱工作人员收集的；因此，被监禁者的声音不存在。
结论：这项研究为设计干预项目提供了坚实的基础，包括制定国家监狱政策和自杀指南，自杀未遂和自残以及针对监狱工作人员的全国性培训计划。这也导致了更好的监控系统，允许趋势分析和更明智的决策。定性结果有助于了解员工如何轻视自我伤害。这已被纳入员工培训计划，导致监狱工作人员培训师的产生，他们成为最强烈的倡导者，反对自残最好被忽视的观念。
结论：据作者所知，这是摩洛哥监狱中首次公布的自杀和自残的数据。它强调了干预项目的必要性，并为非西方监狱背景下的自杀和自残提供了宝贵的见解。需要进一步的研究来评估这些发现是否是该地区的典型。
