Exploring reasons and motivations for suicide attempts in prison before and during the SARS-CoV-2 pandemic

Suicide attempts increased in several prisons during the SARS-CoV-2 pandemic, yet the underlying reasons remain unclear. This study examined 205 suicide attempts—defined as acts of self-harm with serious risk to life—among 125 individuals incarcerated in Switzerland, comparing cases before and during the pandemic. Content analysis of clinical records identified 13 distinct reasons, grouped into three main themes: mental and physical health issues (85%), prison-related problems (76%), and interpersonal conflicts (61%). Notably, 39% of attempts were motivated by protest against the prison institution. Although sample characteristics remained stable across periods, there were significant increases in attempts linked to physical pain (+181%) and dissatisfaction with medical care (+104%) during the pandemic. The findings suggest that reduced access to healthcare during the COVID-19 may have intensified distress among detained persons. Therefore, medical resources during health crises should not be disproportionately focused on managing the disease, but also on addressing the overall health of detained persons.