Working with prisoners who self‐harm: A qualitative study on stress, denial of weakness, and encouraging resilience in a sample of correctional staff

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.

Risk factors for self-harm in prison: a systematic review and meta-analysis

“…Potential publication bias was examined for three risk factors with the largest number of unique samples. Screening of funnel plots (appendix pp [13][14][15] suggests that there was no clear publication bias for violent offending (k=24), single marital status (k=20), and previous selfharm (k=19). Similarly, Egger's test was not significant for violent offending (p=0•68), single marital status (p=0•14), and previous selfharm (p=0 •53).…”

“…11,12 Half of people who die by suicide in prison have a recorded history of selfharm, 9,10 with many deaths occurring within a month of selfharm. 5 In addition, the impact of selfharm extends to other prisoners 13 and to prison staff, 14 and can lead to substantial costs for the prison system, especially if associated with suicide. 15 Transfer of prisoners to local healthcare services for the more severe incidents can further increase costs.…”

Intensification of Type D Personality Traits and Coping Strategies of People Staying in Polish Penitentiary Institutions—Cross-Sectional Study

“…This allows us to assume that people in penitentiary units who experience strong stress feel helpless in the face of their life situation. The feeling of helplessness is a negative phenomenon associated with the occurrence of increased mental tension, which may lead to the occurrence of depressive disorders among prisoners and, consequently, to attempting suicide [ 35 , 46 , 47 , 48 , 49 ].…”

Psychological adjustment in care providers following restraint of psychiatric patients

“…For example, a review of the international literature in 2014 found that 55% of nurses working in psychiatric settings had experienced physical assault during their career (Spector, Zhou, & Che, 2014). In addition to patient aggression directed at others, care providers must also respond to patients engaging in, sometimes gruesome, self‐injurious behaviours (Smith, Power, Usher, Sitren, & Slade, 2019). Thus, care providers face many difficult patient behaviours, and keeping patients and others safe, while they receive appropriate assessment and care, can be a major challenge.…”