Suicide-Related Outcomes Among Adults in Custody: An Umbrella Review of Systematic Literature Reviews

We conducted a comprehensive umbrella review including all published meta-analyses and systematic reviews on suicide-related outcomes among adults in custody. Eligible studies were searched for in major scientific databases following the PRISMA method up to February 2023. The quality of each study was assessed using the AMSTAR-2 protocol. Twenty studies were included, consisting of 11 meta-analyses and nine systematic reviews. Factors associated with suicide outcomes among individuals in custody were categorized into five domains: clinical status, historical, custodial, criminological, and prevention. However, all systematic studies reported considerable heterogeneity (I2 > 50%-85%). Most systematic literature reviews and/or meta-analyses showed moderate quality based on AMSTAR-2. This umbrella review highlights individual factors (in the clinical status and historical domain), contextual factors (in the custodial and criminological domains), and protective factors (in the prevention domain) to provide a clearer understanding of the prison-related domains involved in the development and maintenance of suicide-related outcomes.