Correctional institutions 2.5.5 Health care 2.5.5.1 Suicide and attempted suicide Suicide is the most frequent cause of death in correctional institutions. It happens in the first few hours after admission, after an event that is subjectively perceived as debilitating during detention – be it after a bail hearing, main hearing or public day in court, when expectations have not materialised – or as rational suicide towards the end of serving a sentence. Many incidents The managers of the correctional institutions are obliged to report suicides and attempted suicides in their institutions to the general directorate immediately and in a standardised manner. The reports are forwarded by the general directorate to the NPM who then promptly informs the competent commission. After a decrease of about 50% in the previous year, the number of incidents rose again in the year under review to the level of 2017 and 2018. The 28 reports received by the NPM in 2020 include seven cases with a fatal outcome. The most frequent method used in this year too was hanging by bedclothes suspended from struts in the cells. In two cases, inmates drank a large amount of cleaning agent, two detainees swallowed razor blades. Sharp rise again 2.5.5.2 Adjustment of suicide concept - Linz correctional institution The management of a correctional institution shall ensure that suicidal behaviour is detected in time, correctly assessed and treated through clearly defined guidelines at the time of referral, through continuous observation and psychological-mental intervention for prisoners who are at risk (see “Preventing Suicide”, a manual for employees in correctional service, Department of Mental Health and Substance Abuse, World Health Organization 2007). Common practice was to use the assessment of the previous institution when a detainee was transferred to Linz correctional institution. In the opinion of the NPM, the transfer to another correctional institution requires an adjustment of the assessment of the current state of health of the detainee. Suicidal thoughts can occur at any stage of detention, even in someone who has showed absolutely no signs of such to date and had been classified as “green” according to the Viennese Instrument for Suicidality in Correctional Institutions (VISCI) system. This means that persons who are transferred from another correctional institution should be re-assessed according to the VISCI classification. Moreover, detainees who are acutely at risk and classified “red” should receive constant and regular psychiatric care. No upate On the request of the NPM, the suicide concept of Linz correctional institution was examined by the competent specialist department in the general directorate. The result confirmed that the process of referral to the psychiatrist General directorate also sees need for change 114