Suicide prevention in Latin American prisons: a multiple case study with meta-matrix of policies, programs and protocols in 17 countries

Background: Suicide is one of the most common causes of death in correctional settings. This study aimed to analyse prison suicide prevention policies and procedures across Latin America. <br/><br/>Methods: For this multiple case study, we collected data on prison suicide prevention in policies (laws), programs (institutional framework) and protocols (procedures) from 17 Latin American countries, from (i) the public domain and (ii) archival records held by prison administrations. The search was conducted using Google, through hand search on prison administration websites and requests to public information departments and prison administrations. Theory-driven thematic analysis was conducted based on 11 key components of suicide prevention in prison. Presence and quality of policies, programs and protocols were assessed using tailored instruments. Between country comparisons were made by cross-case analysis. <br/><br/>Results: Data were retrieved from 17 Latin American jurisdictions. Nine cases had a policy or law, 6 had an institutional plan or program, and 13 had suicide prevention protocols. In six of the 17 cases (Argentina, Chile, Colombia, Ecuador, Mexico, and Panama), the three elements were present. Among the 13 cases with protocols, 7 (Argentina, Brazil, Chile, Colombia, Mexico, Paraguay and Uruguay) had high, 2 had medium, and 4 cases had low quantity and quality of key components. In the composite quality assessment of policies, programs and protocols, 3 cases (Argentina, Colombia, and Mexico) had high quality, 4 cases had medium quality, and the other 7 cases had low quality of suicide prevention in place. <br/><br/>Conclusion: Many Latin American countries still need to draft policies and develop institutional frameworks for suicide prevention in prison. Most countries may review their suicide prevention protocols in prisons to cover all key components with clear procedures. Prison administrations in Latin America should publish internal plans and protocols for prison suicide prevention to facilitate cross-country policy evaluations and research.