Pain in Prison: A Risk Factor Analysis of 57 Prisoners' Deaths by Suicide in Illinois, United States.

United States prisons have elevated rates of suicide deaths compared to the general population. Thus, this manuscript aims to identify suicide risk factors, using data collected in Illinois (IL) state prisons between 2013-2021. First, we present comprehensive demographic, psychological, and prison-related descriptive statistics regarding 57 suicide decedents. Next, we compared this subset to IL state population-level prison reports to identify suicide-specific risk factors. Suicide decedents were predominately male, White, serving their first sentence, had a psychiatric diagnosis, and had no work assignment. Lethal attempts frequently occurred during evening off-hours, on Wednesdays, and were preceded by "mental health decompensation" and significant life transitions. Suicide-specific risk factors included identifying as White or Asian, having an offense type of habitual criminal or sex offender, being divorced, and not having children. We close with readily implementable suggestions to reduce suicides in prisons such as increasing off-hours and shift change staffing and social support interventions.