Prevention of suicides in Penal Institutions in The Netherlands.

As in other countries, suicides are a matter of great concern in The Netherlands. This article addresses suicide-prevention measures in prisons in The Netherlands. It focuses primarily on screening, monitoring, incapacitation, psychological support, and transferal to specialized institutions. In addition, it asks which practices are common, which can be improved, and the limitations of certain strategies. Relatively speaking, The Netherlands does not appear to be doing too badly in terms of preventive measures, although there is room for improvement.

Long-term impact of perinatal bereavement. Comparison of grief reactions after intrauterine versus neonatal death.

OBJECTIVE: To investigate possible differences in emotional impact on parents following either a deliberate intrauterine death or a neonatal death in extremely preterm growth retarded infants. DESIGN: Retrospectively matched study by audiotaped semi-structured interview, 3-9 years after the perinatal loss. RESULTS: Nineteen couples (ten in the intrauterine death group and nine in the neonatal death group) consented to participate. More than 50% of the intrauterine death group couples could not share or discuss their emotions. Most partners in this group did not feel the loss of their own child. Discongruent grieving between partners was more pronounced in the intrauterine death group and could be identified as a risk factor for prolonged and abnormal grief reactions. Four couples (three in the intrauterine death group and one in the neonatal death group) developed long-term emotional disturbance and psychosocial problems. Long-term follow-up in both groups was failing remarkably. CONCLUSION: Assimilating a non-intervention policy followed by fetal death requires different skills and is more complicated than grief support around an early neonatal death. Follow-up is essential to identify the couple 'at risk' and to mobilize extra support.