# Suicidal thoughts and self-harm The extreme stresses of detention can lead some people to self-harm, to experience suicidal thoughts or to end their lives. The charity INQUEST collates information and statistics on deaths in immigration custody \[1]. Some people enter detention with a prior history of self-harm or suicidal thinking, which is exacerbated by their incarceration and the threat of deportation or removal. Self-harming and suicide risk is very likely to be adversely impacted by the nature of the detained environment. This includes poor continuity of care and there appears to be little consideration given to the need for clinicians to develop a trusting therapeutic relationship with patients to facilitate the disclosure of psychological symptoms including self-harming and suicidal thoughts and intent. People can find suicidal thinking and self-harming behaviours difficult to talk about with anyone, but especially to medical professionals or detention centre staff who they mistrust \[2]. *** 1. [INQUEST provides expertise on state related deaths and their investigation to bereaved people, lawyers, advice and support agencies, the media and parliamentarians.](https://www.inquest.org.uk/deaths-of-immigration-detainees) 2. [Harmed Not Heard: Failures in safeguarding for the most vulnerable people in immigration detention, Medical Justice, 2022](https://medicaljustice.org.uk/research/harmed-not-heard/) --- # Agent Instructions: Querying This Documentation If you need additional information that is not directly available in this page, you can query the documentation dynamically by asking a question. Perform an HTTP GET request on the current page URL with the `ask` query parameter: ``` GET https://avid-detention.gitbook.io/avid-handbook/safeguards/harms-of-detention-what-safeguarding-concerns-do-visitors-come-across-in-detention/suicidal-thoughts-and-self-harm.md?ask= ``` The question should be specific, self-contained, and written in natural language. The response will contain a direct answer to the question and relevant excerpts and sources from the documentation. Use this mechanism when the answer is not explicitly present in the current page, you need clarification or additional context, or you want to retrieve related documentation sections.