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ObjectivePeople in prison have high rates of self-harm and suicide but little is known about the patterns of occurrence over time in custodial settings. Rates of psychiatric diagnoses in custodial settings are also high, and strong associations have been found between psychiatric diagnoses and risk of self-harm and suicidality.MethodsIn this short report, we present a study examining 3 years of data (2020-2023) from a mental health unit within a prison in New South Wales, Australia. We describe the characteristics of the cohort and report rates of self-harm and suicidal behaviours during the admittance.ResultsOverall, 20% of the cohort reported thoughts of self-harm at least once during their stay, and 9% of the cohort had at least one recorded self-harm incident. Multivariable binary logistic regression analyses revealed greater odds of self-harm for individuals with a recorded history of self-harm or suicidal behaviour and for those who reported thoughts of self-harm to staff during their stay.ConclusionsFindings from our study highlight the high rates of self-harm behaviour and ideation among people with mental illness in a custodial setting, supporting the need for targeted prevention and aftercare strategies.