In their analysis published in The Lancet Psychiatry , Seena Fazel and colleagues show that the risk of suicide in prisons is considerably higher than it is in surrounding communities. 1 Prisons often reflect and amplify the prevalence of health problems in the community, 2 and the finding that higher incarceration rates are associated with lower suicide rates in prison is consistent with this; lower incarceration rates probably indicate a more selected, higher-risk population. Larney and Farrell 3 argue for reducing incarceration of people with severe mental illness and improving access to community care. Although targeted diversion of people with severe mental illness is appropriate, this strategy is insufficient to exclude people at risk of suicide from prisons.