Attitudes Toward Suicide and Self-Harm in the Detention Environment: An Educational Intervention for Nursing

Suicide is a significant public health threat and a leading cause of death in U.S. detention facilities. Detention suicide rates are estimated to be three times greater than in the general population, and suicide is ranked as the number one cause of preventable death among all persons in custody. Nurses are routinely challenged with assessing suicidal detainees, and the attitudes toward suicide and self-harm can positively or negatively influence the outcomes of detention suicide prevention programs. Methods: The Attitudes Toward Prisoners Who Self-Harm (APSH) Scale was administered to nurses (n=21) working in a large U.S. Immigration and Customs Enforcement detention facility to determine current attitudes toward detained non-citizens related to self-harm and suicide. A 30-minute instructional education intervention regarding suicide risk evaluation was provided, followed by a communicative shared experience intervention between the nurses. A secondary survey was obtained 30 days after the training intervention to evaluate any change in nurses' attitudes, pre-intervention versus post-intervention. Results: A repeated measures design was utilized, and paired t-tests were used to evaluate the results from the two 5-point Likert surveys that were collected. The measures were processed with Intellectus Statistics software (Intellectus Statistics [Online computer software], 2023) to evaluate and determine any change in the nurses' attitudes.