• Fatos Kaba, Andrea Lewis, Sarah Glowa-Kollisch, James Hadler, David Lee, Howard Alper, Daniel Selling, Ross MacDonald, Angela Solimo, Amanda Parsons, and Homer Venters.
• All authors are with the New York City Department of Health and Mental Hygiene, Queens, NY.
• Am J Public Health. 2014 Mar 1; 104 (3): 442-7.

ObjectivesWe sought to better understand acts of self-harm among inmates in correctional institutions.MethodsWe analyzed data from medical records on 244 699 incarcerations in the New York City jail system from January 1, 2010, through January 31, 2013.ResultsIn 1303 (0.05%) of these incarcerations, 2182 acts of self-harm were committed, (103 potentially fatal and 7 fatal). Although only 7.3% of admissions included any solitary confinement, 53.3% of acts of self-harm and 45.0% of acts of potentially fatal self-harm occurred within this group. After we controlled for gender, age, race/ethnicity, serious mental illness, and length of stay, we found self-harm to be associated significantly with being in solitary confinement at least once, serious mental illness, being aged 18 years or younger, and being Latino or White, regardless of gender.ConclusionsThese self-harm predictors are consistent with our clinical impressions as jail health service managers. Because of this concern, the New York City jail system has modified its practices to direct inmates with mental illness who violate jail rules to more clinical settings and eliminate solitary confinement for those with serious mental illness.

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