Leaving incarceration presents a unique set of challenges to individuals as they resume their lives in the general community. Persistent barriers to healthcare, stable housing, employment, and social support are often accompanied by the longstanding stigmas associated with serving time in prison. 

A recent study published in the American Journal of Epidemiology found another concerning problem among this population: formerly incarcerated people had double the rate of suicide mortality compared to the general population three years after their release, with the highest risk of suicide occurring within the first two weeks of their release.

These findings underscore the acute vulnerability and fragility that many face as they transition from carceral settings to community living, writes Noel Vest, assistant professor of community health sciences, in an invited commentary also published in the American Journal of Epidemiology.

Based on data from more than 260,000 formerly incarcerated people in North Carolina between 2000 and 2020, the study found that certain groups disproportionately experience a higher and sustained post-incarceration risk of suicide, including female individuals, White, and Hispanic/Latino individuals, and adults in the 18-to-29 age group. Led by Kate Vinita Fitch, research assistant at the University of North Carolina’s Injury Prevention Research Center, the study also showed that formerly incarcerated people had higher rates of non–firearm-involved suicide mortality than firearm-involved suicide mortality, which is contrary to trends in the general population.

“For people with a history of incarceration, like me, the findings are not surprising,” writes Dr. Vest, who has channeled his past experience with incarceration into research that spans substance use disorder, mental health, recidivism, prison reentry interventions, and systemic issues within the US criminal justice system. “The daily dehumanization inflicted on incarcerated people (by correctional staff and administration) and the lack of opportunities postrelease combine in a symbiotic fashion to wear down and demoralize even the most optimistic newly released person.”

The new data underscore the urgent need for long-term support and systemic reforms that promote “equity, justice, and human dignity” for formerly incarcerated individuals’ during and after their return to their communities. In the commentary, Vest identifies tailored support services that can mitigate suicide risks and aid successful community reintegration.

Of chief importance is the need to strengthen and expand reentry programs that offer comprehensive mental health, employment, housing, and other social support to individuals once they are released. These programs, he says, should be led by formerly incarcerated peers, as his own past research demonstrates that people with lived experiences with incarceration, substance use, and poor mental health are uniquely positioned to inform interventions around these issues with their knowledge from personal experience. 

Reentry support to mitigate suicide risk should also be culturally and racially sensitive, and address the broader structural inequalities that perpetuate this burden among disadvantaged groups and those with intersecting vulnerabilities. In practice, this translates into programming such as guaranteed income programs, mental health counseling, job training, education, and a myriad of other resources that address the social determinants of health, Vest says.

“Only through concerted efforts to address the systemic injustices and structural inequalities that perpetuate cycles of incarceration and marginalization can we hope to prevent further loss of life and ensure that all individuals can thrive postrelease,” he writes.