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The statistics are alarming and highlight a stark reality: Individuals in French prisons die by suicide at a rate 10 times higher than the general population — and that risk doubles again for those placed in solitary confinement. Despite numerous suicide-prevention protocols and national plans, the prison environment remains highly conducive to suicidal behavior.

A recent report by the French Prison Administration Directorate (DAP) revealed deeply concerning data: 157 inmates died by suicide in 2023 compared with 139 in 2022 — an increase of 13%. This rise exceeds the overall growth of the prison population. Between 2020 and 2023, the inmate suicide rate increased from 16 to 17.5 per 10,000.

Younger Adults Disproportionately Affected

For the first time, a study presented recently at the Congress of the French Association of Health Professionals Working in Prison provided detailed insight into the medical histories and contextual factors surrounding inmate suicides. Public health researcher Alexis Vanhaesebrouck shared findings from Santé publique France’s analysis of 598 suicides among people in custody between 2017 and 2021.

“Ninety-five percent of those who died were men, and more than half were under the age of 40,” Vanhaesebrouck said. “Nearly half had a diagnosed psychiatric disorder before their incarceration, and we observed a rise in psychiatric conditions that appear to have developed or worsened during imprisonment.”

In addition, one third of the individuals had previously expressed suicidal intent to prison healthcare staff, and suicidal ideation had been documented in one-quarter of the cases prior to the act.

A Traumatic Event Often Precedes the Act

When prison officials were asked whether they were aware of any traumatic event that could have triggered a suicide, one third said they were not. “In cases where they did report a possible cause, it was most often related to judicial outcomes (such as a sentencing), prison conditions like solitary confinement, or personal circumstances such as a request for divorce,” explained Vanhaesebrouck.

He added, “We should consider strengthening the identification and management of suicide risk within prison medical units — and expanding psychiatric services and psychological support for inmates considered vulnerable.”

Suicide Prevention Becomes a National Priority

The French DAP has made suicide prevention a formal priority. A national suicide prevention plan, first introduced in 2009, is regularly updated. Each regional administration and individual prison now has designated “suicide prevention officers.”

A comprehensive guide for suicide prevention in correctional facilities was published in 2023, and the country’s 2024-2028 national health strategy for individuals under judicial supervision highlights suicide prevention as a key objective.

Suicide prevention efforts begin at prison intake. The moment of admission — particularly the initial medical evaluation — is considered high-risk due to the psychological distress that incarceration may trigger. “Eleven percent of inmate suicides between 2017 and 2021 occurred during the first week of incarceration,” Vanhaesebrouck noted. “This represents a suicide rate six times higher than during the remainder of the prison term.”

Staff Training in Suicide Prevention

Many prison staff members have completed the “Terra” suicide prevention training program offered through France’s National School of Prison Administration, with additional continuing education provided.

According to a clinical psychologist and suicide prevention trainer based in western France, “Everyone working in the prison system — whether probation officers, volunteers, or medical staff — has received some level of training. As a result, we’re probably detecting suicidal thoughts more frequently because more people are actively asking about them.”

French prison administrations have established multidisciplinary suicide-prevention committees that meet twice per month at each facility. These meetings bring together correctional staff and healthcare providers to develop tailored interventions for inmates identified as being at high risk for suicide. The proposed measures are recorded in individualized protection plans and are closely monitored.

Peer Support Programs

Since 2014, peer support has been a formal part of suicide prevention strategies in French prisons. Inmates who volunteer for the program receive basic training from the French Red Cross and the National Union for Suicide Prevention. Once trained, they serve as support figures and can be called upon by prison staff to check in on inmates considered psychologically vulnerable. They help identify concerns early and act as intermediaries when needed.

In many correctional institutions across the northern region of France, a follow-up system known as VigilanS has been implemented. This program seeks to reduce repeat suicide attempts by maintaining contact with at-risk individuals — often through the mailing of supportive postcards — and offering ongoing psychological follow-up.

Additionally, the national suicide prevention hotline has recently been piloted in five detention centers: Angers, Brest, Poitiers-Vivonne, Uzerche, and Rouen. This free, confidential service is available 24/7 throughout France and its overseas territories. It provides professional mental health support via trained nurses and psychologists under the supervision of a psychiatrist.

Suicide prevention efforts also extend to inmates preparing for release — a time recognized as psychologically high-risk. Transitional mobile teams, composed of psychiatrists, psychologists, and psychiatric nurses, have been deployed in several regions, including Lille and Toulouse. “These teams help inmates prepare for reentry, as the period following incarceration is highly stressful and can carry an elevated risk of suicide,” explained Lucie Séguret, a fifth-semester psychiatry resident at the specially adapted hospital unit in Seclin, northern France.

This story was translated from Medscape’s French edition.