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Cloud DH, Williams B, Haardöerfer R, Hosbey JT, Cooper HL. Self-injury and the embodiment of solitary confinement among adult men in Louisiana prisons. SSM Popul Health 2023; 22:101354. [PMID: 36865676 PMCID: PMC9971521 DOI: 10.1016/j.ssmph.2023.101354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 01/17/2023] [Accepted: 01/31/2023] [Indexed: 02/04/2023] Open
Abstract
Solitary confinement is a harrowing human rights and public health problem that is currently inflicted as a routine punishment for a litany of prison rule violations, a reactionary tactic to quell resistance to prison conditions, and as a destination of last resort for people serious mental illnesses (SMI) who are especially vulnerable to its harms. An extensive body of research has documented clusters of psychiatric symptoms-emotional distress, cognitive deficits, social withdrawal, anxiety, paranoia, sleeplessness, and hallucinations-linked to solitary confinement that often manifest in decompensating behaviors, which include self-injury and suicide. This study summarizes the historical evolution of solitary confinement, recaps its linkages to self-injury and suicidality, and offers a theoretical framework grounded in ecosocial theory, and supplemented with concepts from theories of dehumanization and carceral geography. Findings bolster extant evidence on the harms of solitary confinement by focusing on whether and how exertions of power by prison staff to deploy mechanisms of dehumanization-as a pathway between SMI and self-injury among a cross section of adult men (n = 517) exposed to solitary confinement in Louisiana prisons in 2017. Findings reinforce the need for structural interventions that diffuse forms of carceral power and practices that continue to subject people to isolation, dehumanization, and violence.
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Affiliation(s)
- David H. Cloud
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, USA,Amend, Center for Vulnerable Populations, University of California San Francisco, School of Medicine, USA,Corresponding author. Emory University, Rollins School of Public Health, 1518 Clifton Rd, Atlanta, GA, 30322, USA.
| | - Brie Williams
- Amend, Center for Vulnerable Populations, University of California San Francisco, School of Medicine, USA
| | - Regine Haardöerfer
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, USA
| | - Justin T. Hosbey
- College of Environmental Design, University of California, Berkeley, USA
| | - Hannah L.F. Cooper
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, USA
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2
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Taylor P. Challenging the Myth of "Attention Seeking" Women with Suicidality: A Grounded Theory Study about Applying Counter-Pressure to Manage System Entrapment. Issues Ment Health Nurs 2022; 43:613-624. [PMID: 35026123 DOI: 10.1080/01612840.2021.2014608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Some women who express suicidal intent and engage in non-lethal self-harm perceive that nurses and other health care workers label them as attention-seeking and manipulative. An understanding of women's help-seeking behaviors that challenges suicide myths is presented. The purpose of this study was to examine help-seeking for suicidality in women with histories of intimate partner violence using a multiple qualitative research design of grounded theory and photovoice. Women from New Brunswick, Canada, over the age of 19 who left an abusive partner (n = 32) were interviewed and seven local women from this sample participated in five photovoice group sessions where they collectively examined self-generated photos of their experiences. Transcripts of the interviews and group sessions were analyzed using the constant comparative approach, yielding a theoretical rendering of women's help seeking. Results include a process of Applying Counter-Pressure as a way of pushing back against System Entrapment, or the sense of being invalidated and dehumanized by health care providers with the goal to Feel Human. Findings provide an understanding of women's behavior when seeking help for suicidality and may reduce nurses' assumptions and judgments when providing care. Trauma and violence informed care provides a framework from which to guide interventions that acknowledge the role of past and ongoing trauma in women's lives, supporting nurses' capacity to be validating and helping women to continue living.
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Affiliation(s)
- Petrea Taylor
- Faculty of Nursing, University of New Brunswick, Moncton, New Brunswick, Canada
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3
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Hewson T, Gutridge K, Bernard Z, Kay K, Robinson L. A systematic review and mixed-methods synthesis of the experiences, perceptions and attitudes of prison staff regarding adult prisoners who self-harm. BJPsych Open 2022; 8:e102. [PMID: 35659128 PMCID: PMC9230562 DOI: 10.1192/bjo.2022.70] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Self-harm, including suicide, is common among prisoners. Staff attitudes and perceptions regarding self-harm may affect quality of care and patient safety. AIMS To systematically review the experiences, perceptions and attitudes of staff in adult prisons regarding self-harm. METHOD Systematic searches of EMBASE, Medline, PsycINFO and CINAHL databases were conducted, and supplemented by hand-searching and grey literature review, to identify relevant English-language articles published since the year 2000. Articles were screened by two authors and evaluated with standardised quality appraisal tools. Qualitative data were analysed thematically, whereas quantitative data were narratively synthesised because of high study heterogeneity. RESULTS Two thousand articles were identified, of which 32 were included, involving 6389 participants from five countries. Most studies were moderate (n = 15) or poor (n = 10) quality, and seven were rated as good quality. Staff frequently witnessed self-harm and described multiple perceived risk factors and causes of this. Perceptions that self-harm is 'manipulative' or 'attention-seeking' were associated with hostility toward prisoners and lower quality of care. Perceived barriers to preventing and managing self-harm included low staffing levels, prison environments and culture, poor staff confidence and insufficient training. The importance of multidisciplinary teamwork and building staff-prisoner relationships were highlighted. Staff occasionally experienced intense psychological reactions to self-harm, which resulted in adaptive or maladaptive coping that influenced their capacity to care. CONCLUSIONS There are mixed attitudes and perceptions toward self-harm among prison staff. Further training, support and resources are required to protect staff's well-being and improve self-harm prevention and management in prisons.
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Affiliation(s)
- Thomas Hewson
- Faculty of Biology, Medicine and Health, University of Manchester, UK; and North West School of Psychiatry, Health Education England, University of Manchester, UK
| | - Kerry Gutridge
- Centre for Women's Mental Health, University of Manchester, UK
| | - Zara Bernard
- Greater Manchester Mental Health NHS Foundation Trust, UK
| | - Kathryn Kay
- Greater Manchester Mental Health NHS Foundation Trust, UK
| | - Louise Robinson
- Division of Psychology and Mental Health, University of Manchester, UK; and Lancashire and South Cumbria NHS Foundation Trust, UK
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Ekanem OJ, Woods P. Effectiveness of Nonsuicidal Self-Injury Interventions among Incarcerated Women in Correctional Facilities and Secure Settings: An Integrative Review. Issues Ment Health Nurs 2022; 43:220-238. [PMID: 34499564 DOI: 10.1080/01612840.2021.1967532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Nonsuicidal self-injury (NSSI) is prevalent among incarcerated women in correctional facilities. This poses a challenge in selecting appropriate intervention. This integrative review aimed to identify effective interventions for managing NSSI among incarcerated women. Whittemore and Knafl's framework for integrative reviews was used, and eight databases were searched with 11 papers meeting the inclusion criteria. Six interventions for NSSI for incarcerated women were identified as promising in reducing the rate of NSSI. Data did not support the effectiveness of gender-specific interventions for incarcerated women. There is a need for further research to identify appropriate interventions to target NSSI among incarcerated women.
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Affiliation(s)
| | - Phil Woods
- College of Nursing, University of Saskatchewan, Saskatoon, Canada
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5
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Bright AM, Higgins A, Grealish A. Women's experiences of prison-based mental healthcare: a systematic review of qualitative literature. Int J Prison Health 2022; 19:181-198. [PMID: 35192246 PMCID: PMC10427976 DOI: 10.1108/ijph-09-2021-0091] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 11/25/2021] [Accepted: 01/11/2022] [Indexed: 11/17/2022]
Abstract
PURPOSE The rate of female committals to prison has grown rapidly in recent years. Women in prison are likely to have trauma histories and difficulties with their mental health. This paper aims to synthesise the findings of qualitative literature to gain a deeper understanding of the experiences of women in the context of prison-based mental health care. DESIGN/METHODOLOGY/APPROACH A systematic search of five academic databases, Cumulative Index to Nursing and Allied Health Literature, Applied Social Sciences Index and Abstracts, Psychological Information Database (PsycINFO), Excerpta Medica DataBASE (EMBASE) and Medline, was completed in December 2020. This study's search strategy identified 4,615 citations, and seven studies were included for review. Thomas and Harden's (2008) framework for thematic synthesis was used to analyse data. Quality appraisal was conducted using the Joanna Briggs Institute Checklist for Qualitative Research (Lockwood et al., 2015). FINDINGS Four analytic themes were identified that detail women's experiences of prison-based mental health care: the type of services accessed and challenges encountered; a reduction in capacity to self-manage mental well-being; the erosion of privacy and dignity; and strained relationships with prison staff. There is a paucity of research conducted with women in the context of prison-based mental health care. The findings suggest there is a need for greater mental health support, including the need to enhance relationships between women and prison staff to promote positive mental health. ORIGINALITY/VALUE To the best of the authors' knowledge, this is the first systematic review conducted on the experiences of women in the context of prison-based mental health care.
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Affiliation(s)
- Ann-Marie Bright
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
| | - Agnes Higgins
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Annmarie Grealish
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland and Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King’s College London, London, UK
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6
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Nilsson M, Lundh L, Westling S. Childhood maltreatment and self-hatred as distinguishing characteristics of psychiatric patients with self-harm: A comparison with clinical and healthy controls. Clin Psychol Psychother 2022; 29:1778-1789. [PMID: 35467060 PMCID: PMC9790602 DOI: 10.1002/cpp.2744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 04/19/2022] [Accepted: 04/20/2022] [Indexed: 12/30/2022]
Abstract
INTRODUCTION Deliberate self-harm (DSH) is common in clinical populations. Childhood maltreatment (CM) and attitudes both towards oneself and towards DSH may be of importance for the development of DSH. This study aimed to test whether patients with DSH report more CM, more negative attitudes towards oneself and more positive attitudes towards DSH than a clinical and a healthy comparison group, and whether the effects of CM are mediated by negative attitudes towards oneself. METHOD Females with DSH and psychiatric disorders (n = 34), females without DSH but with psychiatric disorders (n = 31) and healthy female individuals (n = 29) were compared regarding DSH, CM, attitudes towards the self and attitudes towards self-harm. RESULTS Females with DSH reported more emotional abuse and more self-hatred as compared to both comparison groups. The effect of emotional abuse was mediated by self-hatred. The DSH-group had significantly more positive attitudes towards DSH than the healthy comparison group. CONCLUSION Self-hatred and CM in the form of emotional abuse may be distinguishing characteristics of female patients with DSH in psychiatric settings. The present results are compatible with the hypothesis that emotional abuse leads to DSH via self-hatred, but the cross-sectional nature of the study precludes any causal conclusions. The clinical utility of the results is discussed.
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Affiliation(s)
- Magnus Nilsson
- Department of Clinical Sciences, PsychiatryLund UniversityLundSweden
| | | | - Sofie Westling
- Clinical Psychiatric Research CenterRegion SkåneLundSweden
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Augustine D, Barragan M, Chesnut K, Pifer NA, Reiter K, Strong JD. Window dressing: possibilities and limitations of incremental changes in solitary confinement. HEALTH & JUSTICE 2021; 9:21. [PMID: 34333731 PMCID: PMC8325829 DOI: 10.1186/s40352-021-00145-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 06/28/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND In light of mounting evidence of the physical and psychological harms associated with solitary confinement, many correctional systems, state legislators, courts, and even international human rights bodies are increasingly recommending and implementing reforms to mitigate the harms of solitary confinement, if not abolish the practice entirely. In this piece, we examine three specific infrastructural changes to solitary confinement conditions and practices implemented in Washington state prisons with such harm minimization goals in mind: (1) building so-called "nature imagery rooms" to play videos of outdoor spaces, (2) eliminating punishments for self-harm, and (3) conducting daily cell-front wellness checks. RESULTS Drawing on 183 in-depth qualitative interviews with both staff working in and people imprisoned in solitary confinement units conducted in Washington state restrictive housing units in 2017, we find that these three reforms not only resulted in limited successes but also generated new conflicts. Institutional logics such as deprivation, risk-management, and responsibilization ultimately impeded even the most modest attempts to mitigate the inherently harsh practice of solitary confinement. The limits of these reforms are due in part to individual choices made by people imprisoned in solitary confinement and staff working in these units, as well as the larger cultural norms that shape life in restrictive housing units. CONCLUSIONS Incrementalist reforms aimed at softening the environment of solitary confinement may actually serve to increase the strain and stress experienced by people confined to and working within them. Even the most well-intentioned reforms, like those attempted by the Washington DOC, should be scrutinized in order to determine if they are producing the desired outcomes, or instead, reproducing a different, but nonetheless damaging set of harms to people imprisoned in solitary confinement. Further, even well-intentioned reforms are often stymied by the underlying institutional logics of restrictive housing spaces.
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Affiliation(s)
- Dallas Augustine
- Department of Medicine, University of California, San Francisco, USA.
| | - Melissa Barragan
- Department of Sociology, California State Polytechnic University at Pomona, Pomona, USA
| | | | - Natalie A Pifer
- Department of Criminology and Criminal Justice, University of Rhode Island, Kingston, USA
| | - Keramet Reiter
- Department of Criminology, Law & Society, University of California, Irvine, USA
| | - Justin D Strong
- Department of Criminology, Law & Society, University of California, Irvine, USA
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8
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Shafti M, Taylor PJ, Forrester A, Pratt D. The Co-occurrence of Self-Harm and Aggression: A Cognitive-Emotional Model of Dual-Harm. Front Psychol 2021; 12:586135. [PMID: 33716854 PMCID: PMC7946988 DOI: 10.3389/fpsyg.2021.586135] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 01/29/2021] [Indexed: 11/29/2022] Open
Abstract
There is growing evidence that some individuals engage in both self-harm and aggression during the course of their lifetime. The co-occurrence of self-harm and aggression is termed dual-harm. Individuals who engage in dual-harm may represent a high-risk group with unique characteristics and pattern of harmful behaviours. Nevertheless, there is an absence of clinical guidelines for the treatment and prevention of dual-harm and a lack of agreed theoretical framework that accounts for why people may engage in this behaviour. The present work aimed to address this gap in the literature by providing a narrative review of previous research of self-harm, aggression and dual-harm, and through doing so, presenting an evidence-based theory of dual-harm – the cognitive-emotional model of dual-harm. This model draws from previous studies and theories, including the General Aggression Model, diathesis-stress models and emotional dysregulation theories. The cognitive-emotional model highlights the potential distal, proximal and feedback processes of dual-harm, the role of personality style and the possible emotional regulation and interpersonal functions of this behaviour. In line with our theory, various clinical and research implications for dual-harm are suggested, including hypotheses to be tested by future studies.
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Affiliation(s)
- Matina Shafti
- Division of Psychology and Mental Health, School of Health Sciences, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
| | - Peter James Taylor
- Division of Psychology and Mental Health, School of Health Sciences, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
| | - Andrew Forrester
- Division of Psychological Medicine and Clinical Neuroscienecs, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Daniel Pratt
- Division of Psychology and Mental Health, School of Health Sciences, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
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9
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Walker T, Shaw J, Gibb J, Turpin C, Reid C, Gutridge K, Abel K. Lessons Learnt From the Narratives of Women Who Self-Harm in Prison. CRISIS 2020; 42:255-262. [PMID: 32845178 DOI: 10.1027/0227-5910/a000714] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background: In England and Wales, women in prison make up a minority (<5%) of the total custodial population, yet acts of self-harm are around five times more common among incarcerated women. While there has been a multiagency effort to improve how acts of self-harm are documented across prisons, the patterns and functions of self-harm for women in prison have not yet been fully addressed. Aims: We aimed to determine the patterns, prevalence, and functions of self-harm among women in prison through a mixed-methods study. Method: A total of 108 women with a history of self-harm were interviewed across three female prisons. Participants completed a structured questionnaire detailing their experiences of self-harm across prison and community settings. Results: We found that women in prison who frequently self-harmed disclosed high levels of trauma: past experiences of domestic violence (81.5%), childhood sexual abuse (66.7%), and adult sexual abuse (60.2%). Prevalent methods of recent in-prison acts of self-harm involved cutting, followed by ligaturing. Limitations: The study used a cross-sectional design, self-reported data, and featured a subset of women identified as being at high-risk of self-harm. Conclusion: Motivations behind acts of self-harm by women in prison are complex. Triggers appear to be past trauma, deteriorating mental health, and separation from children or family.
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Affiliation(s)
- Tammi Walker
- Department of Psychology, University of Manchester, UK
| | - Jenny Shaw
- Offender Health Research Network, University of Manchester, UK
| | - Jonathan Gibb
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Clive Turpin
- Greater Manchester Mental Health Trust, Prestwich, Manchester, UK
| | - Catherine Reid
- School of Psychology, Newcastle University, Newcastle upon Tyne, UK
| | - Kerry Gutridge
- Centre for Women's Mental Health, University of Manchester, UK
| | - Kathryn Abel
- Centre for Women's Mental Health, University of Manchester, UK
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10
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Hemming L, Bhatti P, Shaw J, Haddock G, Pratt D. Words Don't Come Easy: How Male Prisoners' Difficulties Identifying and Discussing Feelings Relate to Suicide and Violence. Front Psychiatry 2020; 11:581390. [PMID: 33362602 PMCID: PMC7758448 DOI: 10.3389/fpsyt.2020.581390] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 11/11/2020] [Indexed: 11/16/2022] Open
Abstract
Suicide and violence are prevalent within male prisons in the UK. It has been suggested that alexithymia may be associated with both suicide and violence. Alexithymia can be defined as an inability to identify or discuss emotions. The present study aimed to qualitatively explore male prisoners' experiences of alexithymia and how these experiences may relate to suicide and violence. Fifteen male prisoners were recruited from two prisons in the North West of England. All participants had experienced suicidal and/or violent thoughts and/or behaviors in the past 3 months, and all screened positive on an established measure of alexithymia. Participants took part in a qualitative interview during which they were also given the opportunity to provide drawings of their emotions. Data were transcribed and analyzed using thematic analysis, with a collaborative approach taken between researchers and an individual with lived experience of residing in prison. The results indicated that male prisoners tended not to talk about their emotions with others, due to external pressures of residing in prison in addition to internal difficulties with recognizing and articulating emotions. Not discussing emotions with others was associated with a build-up of emotions which could result in either an emotional overload or an absence of emotions. Both experiences were perceived to be associated with hurting self or others, however, participants also identified a "safety valve" where it was acknowledged that using more adaptive approaches to releasing emotions could prevent harm to self and others. These findings suggest three main clinical implications; (1) a cultural shift in male prisons is needed which encourages open communication of emotions (2) individualized support is needed for those identified as experiencing a difficulty in recognizing and articulating emotions and (3) prison staff should encourage alternative ways of releasing emotions such as by using harm minimization or distraction techniques.
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Affiliation(s)
- Laura Hemming
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, United Kingdom.,Manchester Academic Health Sciences Centre, Manchester, United Kingdom
| | - Peer Bhatti
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, United Kingdom.,Manchester Academic Health Sciences Centre, Manchester, United Kingdom
| | - Jennifer Shaw
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, United Kingdom.,Manchester Academic Health Sciences Centre, Manchester, United Kingdom.,Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
| | - Gillian Haddock
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, United Kingdom.,Manchester Academic Health Sciences Centre, Manchester, United Kingdom.,Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
| | - Daniel Pratt
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, United Kingdom.,Manchester Academic Health Sciences Centre, Manchester, United Kingdom.,Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
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11
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Sousa M, Gonçalves RA, Cruz AR, de Castro Rodrigues A. Prison officers' attitudes towards self-harm in prisoners. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2019; 66:101490. [PMID: 31706411 DOI: 10.1016/j.ijlp.2019.101490] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 07/13/2019] [Accepted: 08/08/2019] [Indexed: 06/10/2023]
Abstract
Prison officers are the agents that have the most contact with prisoners during imprisonment and are essential for control prisoners at risk. Because of that, it is essential to understand their attitudes towards prisoners who self-harm because their attitudes predispose the behavior in situations of self-harm. Thus, our study aimed to explore the attitudes of prison officers regarding prisoners who self-harm. The results revealed that prison officers did not advocate harsh treatment for self-harming prisoners. However, they tend to reveal some difficulties in understanding the causes of self-harm, reproducing the negative myths referred to in the literature. They also tend to neglect the fact that these behaviors may, in some cases, culminate in suicide. These results highlight the need for specific training about this phenomenon, not only in prison officers initial training but also in continuing training, identifying issues of particular importance to address, such as interpersonal skills and behavioral strategies to deal with incarcerated individuals who self-harm. We also advocate for the importance of reinforcing prison officers' role as first-line responders, empowering these agents in their social responsibility towards prisoners well being and the way penal justice is implemented.
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Affiliation(s)
- Marta Sousa
- CIPsi (Center of Research in Psychology), School of Psychology, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal.
| | - Rui Abrunhosa Gonçalves
- CIPsi (Center of Research in Psychology), School of Psychology, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal
| | - Ana Rita Cruz
- CIPsi (Center of Research in Psychology), School of Psychology, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal
| | - Andreia de Castro Rodrigues
- CIPsi (Center of Research in Psychology), School of Psychology, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal; Faculty of Law, University Lusíada North (Porto), Rua Dr. Lopo de Carvalho, 4369-006 Porto, Portugal
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12
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Smith HP, Power J, Usher AM, Sitren AH, Slade K. Working with prisoners who self-harm: A qualitative study on stress, denial of weakness, and encouraging resilience in a sample of correctional staff. CRIMINAL BEHAVIOUR AND MENTAL HEALTH : CBMH 2019; 29:7-17. [PMID: 30609122 DOI: 10.1002/cbm.2103] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 03/23/2018] [Accepted: 11/27/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Rates of self-harm are high among prisoners. Most research focuses on the vulnerable prisoner, and there is little on the impact of these behaviours on staff. AIMS To investigate staff perceptions of self-harming behaviours by prisoners, including their views on its causes, manifestation, prevention in institutions, and impact on them. METHODS Semistructured interviews were conducted with 20 administrative and 21 therapeutic prison staff who are responsible in various ways for prisoners who self-harm. Their narratives were explored using interpretative phenomenological analysis. RESULTS Despite prison staff being experienced with prisoners' self-harming behaviours, including severe acts of self-harm, they were apt to reject any negative impact on their own mental health or well-being. This denial of negative impact was accompanied by perceptions of the inmate's actions being manipulative and attention seeking. Prison staff also perceived institutional responses to self-harming behaviours by prisoners as being mixed, ambiguous, or showing preference for relying on existing suicide protocols rather than task-specific guidance. CONCLUSIONS Although staff gave explanations of prisoner self-harm in terms of "manipulative behaviour," prisoners' self-harm is, in fact, complex, challenging, and often severe. This staff perception may reflect denial of impact of often distressing behaviours on them personally and their own coping mechanisms. This could be feeding in to a perceived lack of clear and effective institutional responses to the self-harm, so further research is needed to determine how staff could broaden their views, and respond more effectively to prisoners. Psychologically informed group work and/or reflective practice are among the candidates for such help for staff.
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Affiliation(s)
- Hayden P Smith
- Department of Criminology & Criminal Justice, University of South Carolina, Columbia, SC, USA
| | - Jenelle Power
- Department of Psychology, Carleton University, Ottawa, Ontario, Canada
| | - Amelia M Usher
- Department of Psychology, Ryerson University, Toronto, Ontario, Canada
| | - Alicia H Sitren
- Department of Criminology & Criminal Justice, University of North Florida, Jacksonville, FL, USA
| | - Karen Slade
- College of Business Law and Social Sciences, School of Social Sciences, Nottingham Trent University, Nottingham, UK
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Mitchell H, Abel KM, Dunlop BJ, Walker T, Ranote S, Robinson L, Edgar F, Millington T, Meacock R, Shaw J, Gutridge K. Acceptability and feasibility pilot randomised controlled trial of medical skin camouflage for recovery of women prisoners with self-harm scarring (COVER): the study protocol. BMJ Open 2019; 9:e021891. [PMID: 30782675 PMCID: PMC6340434 DOI: 10.1136/bmjopen-2018-021891] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION Self-harm in prison is a major public health concern. Less than 5% of UK prisoners are women, but they carry out more than a fifth of prison self-harm. Scars resulting from self-harm can be traumatising and stigmatising, yet there has been little focus on recovery of women prisoners with self-harm scarring. Medical skin camouflage (MSC) clinics treat individuals with disfiguring skin conditions, with evidence of improved well-being, self-esteem and social interactions. Only one community study has piloted the use of MSC for self-harm scarring. METHODS AND ANALYSIS We describe an acceptability and feasibility pilot randomised controlled trial; the first to examine MSC for women prisoners who self-harm. We aim to randomise 20-25 women prisoners to a 6-week MSC intervention and 20-25 to a waitlist control (to receive the MSC after the study period). We aim to train at least 6-10 long-term prisoners with personal experience of self-harm to deliver the intervention. Before and after intervention, we will pilot collection of women-centred outcomes, including quality of life, well-being and self-esteem. We will pilot collection of self-harm incidents during the intervention, resources used to manage/treat self-harm and follow-up of women at 12 weeks from baseline. Data on recruitment, retention and dropout will be recorded. We aim for the acceptability of the intervention to prison staff and women prisoners to be explored in qualitative interviews and focus groups. ETHICS AND DISSEMINATION Ethical approval for COVER has been granted by the North East-York Research Ethics Committee (REC) for phases 1 and 2 (reference: 16/NE/0030) and West of Scotland REC 3 for phases 3 and 4 (reference: 16/WS/0155). Informed consent will be the primary consideration; it will be made clear that participation will have no effect on life in prison or eligibility for parole. Due to the nature of the study, disclosures of serious self-harm may need to be reported to prison officials. We aim for findings to be disseminated via events at the study prison, presentations at national/international conferences, journal publications, prison governor meetings and university/National Health Service trust communications. TRIAL REGISTRATION NUMBER NCT02638974; Pre-results.
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Affiliation(s)
- Heather Mitchell
- Centre for Women’s Mental Health, Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
- Greater Manchester Mental Health NHS Foundation Trust, Prestwich, UK
| | - Kathryn M Abel
- Centre for Women’s Mental Health, Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
- Greater Manchester Mental Health NHS Foundation Trust, Prestwich, UK
| | - Brendan James Dunlop
- Centre for Women’s Mental Health, Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
- Greater Manchester Mental Health NHS Foundation Trust, Prestwich, UK
| | - Tammi Walker
- Department of Psychology, School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK
| | - Sandeep Ranote
- North West Boroughs Healthcare NHS Foundation Trust, Warrington, United Kingdom
| | - Louise Robinson
- Lancashire Care NHS Foundation Trust, Preston, UK
- Centre for Mental Health and Risk, Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Fiona Edgar
- Centre for Women’s Mental Health, Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
- Mental Health and Criminal Justice Group, University of Central Lancashire, Preston, UK
| | - Tracy Millington
- Centre for Women’s Mental Health, Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Rachel Meacock
- Manchester Centre for Health Economics, Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Jenny Shaw
- Offender Health Research Network, Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester. Manchester Academic Health Science Centre, Manchester, UK
| | - Kerry Gutridge
- Centre for Women’s Mental Health, Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
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Selenius H, Strand S. Experiences of self-injury and aggression among women admitted to forensic psychiatric care. Nord J Psychiatry 2017; 71:304-311. [PMID: 28152333 DOI: 10.1080/08039488.2017.1283443] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Self-injury and institutional violence are well-known characteristics of female forensic psychiatric patients, but research on patients' experiences of these behaviours is limited. AIM The aim of the study was to investigate how female forensic psychiatric patients describe their self-injury and aggression. METHODS The authors performed qualitative in-depth interviews with 13 female forensic psychiatric inpatients. The interviews were analysed using thematic analysis. RESULTS The analysis resulted in three themes describing the process of handling negative thoughts and emotions by using self-injury or aggression towards others and thereby experiencing satisfaction. Both self-injury and aggression were experienced as strategies for emotional regulation. The forensic psychiatric care was perceived as important for the women in developing less harmful strategies for coping with negative thoughts and emotions instead of injuring themselves or others. CONCLUSIONS Self-injury and aggression are often risk-assessed separately, but results from the present study suggest that these behaviours need a more holistic approach.
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Affiliation(s)
- Heidi Selenius
- a School of Law, Psychology and Social Work, Örebro University , Örebro , Sweden.,b Department of Special Education , Stockholm University , Stockholm , Sweden
| | - Susanne Strand
- a School of Law, Psychology and Social Work, Örebro University , Örebro , Sweden.,c Centre for Forensic Behavioural Science, Swinburne University of Technology , Melbourne , Australia
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Howard R, Karatzias T, Power K, Mahoney A. From Childhood Trauma to Self-Harm: An Investigation of Theoretical Pathways among Female Prisoners. Clin Psychol Psychother 2016; 24:942-951. [DOI: 10.1002/cpp.2058] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Revised: 10/13/2016] [Accepted: 10/17/2016] [Indexed: 11/06/2022]
Affiliation(s)
- Ruth Howard
- Edinburgh Napier University, School of Health and Social Care; Edinburgh UK
| | - Thanos Karatzias
- Edinburgh Napier University, School of Health and Social Care; Edinburgh UK
- NHS Lothian, Rivers Centre for Traumatic Stress; Edinburgh UK
| | - Kevin Power
- NHS Tayside, Psychological Therapies Service; Dundee UK
- Stirling University, School of Natural Sciences; Stirling UK
| | - Adam Mahoney
- HMP YOI Cornton Vale, Scottish Prison Service; Stirling UK
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Gardner KJ, Dodsworth J, Klonsky ED. Reasons for Non-Suicidal Self-Harm in Adult Male Offenders With and Without Borderline Personality Traits. Arch Suicide Res 2016; 20:614-34. [PMID: 26953689 DOI: 10.1080/13811118.2016.1158683] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The presented study aimed to advance understanding of the reasons for non-suicidal self-harm (NSSH) in adult male offenders, with and without borderline personality traits. 179 offenders completed self-report measures of NSSH and other clinical constructs, with 42 being identified as having self-harmed. Results were consistent with past research and supported the relative importance of intrapersonal over interpersonal functions, but also highlight that self-harm is performed rarely for one type of reason. The results also show that the presence of borderline personality traits increases the likelihood of endorsing a range of interpersonal reasons. These findings highlight the importance of understanding the range of reasons for engaging in NSSH to help manage the behaviour within the prison.
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Cook TB. Recent criminal offending and suicide attempts: a national sample. Soc Psychiatry Psychiatr Epidemiol 2013; 48:767-74. [PMID: 22918292 DOI: 10.1007/s00127-012-0567-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2012] [Accepted: 08/03/2012] [Indexed: 10/28/2022]
Abstract
PURPOSE Few studies have assessed the risk of suicide and suicidal behavior among the community-residing population with recent criminal justice involvement despite evidence of high rates of suicide in jails and prisons. This study assessed the association between recent arrest history and a suicide attempt in the previous year including multiple arrests and specific offense categories using a national representative sample of adults. METHODS Data were derived from 2 years of the National Survey on Drug Use and Health (2008 and 2010), a nationally representative cross-sectional survey of non-institutionalized US adults. Suicide attempts in the previous year based on self-report were assessed in relation to recent arrest history while accounting for socio-demographic factors, mental and physical health status and substance use. RESULTS Suicide attempts in the previous year are relatively common among those with recent arrests (2.3 %) compared to the general US population (0.4 %), with much higher prevalence among those with multiple recent arrests or charges (4.5 %). The prevalence of recent suicide attempts among those with multiple recent arrests was highest among adults aged 25-34 (5.7 %), with similar risks between men and women, and across racial and ethnic subgroups. There was no association between arrests prior to the most recent year and recent suicide attempts. CONCLUSIONS Suicide attempts are common among the non-institutionalized population of US adults with recent criminal justice involvement. Suicide prevention efforts in the criminal justice system should extend to clients who remain in the community both during and immediately following periods of court-processing. Future research is needed to better identify case and client characteristics indicating the highest suicide risk.
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Affiliation(s)
- Thomas Bradley Cook
- Center for Health Disparities Research and Education, Baldwin Wallace University, 275 Eastland Road, Berea, OH 44017, USA.
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Ward J, de Motte C, Bailey D. Service user involvement in the evaluation of psycho-social intervention for self-harm: a systematic literature review. J Res Nurs 2012. [DOI: 10.1177/1744987112461782] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background The efficacy of interventions and treatments for self-harm is well researched. Previous reviews of the literature have highlighted the lack of definitively effective interventions for self-harm and have highlighted the need for future research. These recommendations are also reflected in clinical guidelines published by the National Institute for Health and Clinical Excellence ( NICE, 2004 ) which also call for service user involvement in studies of treatment efficacy. Aims A systematic review was undertaken to determine: a) what contributions service users have made to the evaluation of psycho-social interventions; b) by what methods have service users been involved; c) in what ways could service user involvement supplement empirical evidence for interventions. Methodology Electronic searches were completed on the 28th January 2011 of the Medline (1950–present), Web of Science (1898–Present), Web of Science (including Science Citation Index and the Social Science Citation Index), the Cochrane database of systematic reviews, and Psychinfo (1979–present) databases using a combination of 13 search terms. References were independently sifted according to set criteria by two of the authors to ensure inter-rater reliability. Results Sixty-five references were included in the review. Of these, 59% of studies were empirically based, and 26% used qualitative data collection methods to gather service user narratives. Only 8% of studies used a mixed-methodology to combined qualitative and quantitative data collection. No studies featured service user involvement. Conclusion Service user involvement is a rarity in the evaluation of psycho-social interventions, despite its use being mandated by the National Institute for Health and Clinical Excellence and evidenced as effective in other areas of mental health ( Leader, 1998 ). The authors make a number of recommendations for future involvement in future self-harm research.
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Affiliation(s)
- James Ward
- Research Associate, School of Applied Social Sciences, Durham University, UK
| | - Claire de Motte
- Research Assistant, School of Social Sciences, Nottingham Trent University, UK
| | - Di Bailey
- Head of Division of Social Work and Professional Practice, School of Social Sciences, Nottingham Trent University, UK
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Knowles SE, Townsend E, Anderson MP. ‘In two minds’ – socially motivated self-harm is perceived as less serious than internally motivated: A qualitative study of youth justice staff. J Health Psychol 2012; 18:1187-98. [DOI: 10.1177/1359105312459874] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Community-based young offenders are at high risk of self-harm and unlikely to be in contact with mental health services. Semi-structured interviews with community youth justice staff and a content analysis of 50 records of self-harm not only revealed staff concerns about the impact of stigma on disclosure and service use, but also found dismissive attitudes towards socially motivated self-harm, which was equated with lower suicide risk and less emotional distress. Efforts to improve identification of self-harm will need to address the perceived – and false – distinction between ‘genuine’ and socially motivated self-harm.
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