Search results

1 – 10 of over 32000
Click here to view access options
Article
Publication date: 30 December 2021

Linsey Ann Belisle and Elia Del Carmen Solano-Patricio

As prison drug use continues to be a concern worldwide, harm reduction practices serve as an alternative approach to traditional abstinence-only or punishment-oriented…

Abstract

Purpose

As prison drug use continues to be a concern worldwide, harm reduction practices serve as an alternative approach to traditional abstinence-only or punishment-oriented methods to address substance use behind bars. The purpose of this study is to present a summary of research surrounding prison-based harm reduction programs.

Design/methodology/approach

This narrative review of the international literature summarizes the harms associated with prison drug use followed by an overview of the literature surrounding three prison-based harm reduction practices: opioid agonist therapy, syringe exchange programs and naloxone distribution.

Findings

A collection of international research has found that these three harm reduction programs are safe and feasible to implement in carceral settings. Additionally, these services can effectively reduce some of the harms associated with prison drug use (e.g. risky injection practices, needle sharing, fatal overdoses, etc.). However, these practices are underused in correctional settings in comparison to their use in the community.

Originality/value

Various policy recommendations are made based on the available literature, including addressing ethical concerns surrounding prison populations’ rights to the same standard of health care and services available in the community. By taking a public health approach to prison drug use, harm reduction practices can provide a marginalized, high-risk population of incarcerated individuals with life-saving services rather than punitive, punishment-oriented measures.

Details

International Journal of Prisoner Health, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1744-9200

Keywords

Click here to view access options
Article
Publication date: 5 January 2022

Molly Cross and Tim Clarke

In response to elevated local self-harm and suicide rates, and the lack of a dedicated pathway for children and young people (CYP) who self-harm, a rapid response pathway…

Abstract

Purpose

In response to elevated local self-harm and suicide rates, and the lack of a dedicated pathway for children and young people (CYP) who self-harm, a rapid response pathway united to reduce self-harm (RUSH) was developed and implemented within Norwich (Norfolk, England). This public health case study aims to describe the pathway model and share its outcomes, learnings, and reflections over the pilot year.

Design/methodology/approach

RUSH was a community-based pilot pathway aiming to support CYP, 11–18 years old, engaging in or at risk of engaging in repeated self-harm and subsequently at risk of repeated attendance at local emergency departments. From May 2020 to April 2021, RUSH supported 61 CYP using funding from NHS England and Improvement.

Findings

This case study shares the pathway’s outcomes, through a mixed-method evaluation. Results indicate statistically significant reductions in self-harm frequency (p = 0.01) and anxiety and depression symptomatology (p < 0.001); a statistically significant increase in progress towards goals (p < 0.001); and a general downward trend in re-attendance at local emergency departments following RUSH. Findings also illustrate high service user satisfaction. Framework analysis of focus group data highlights positive experiences with hope for recommissioning from a staff perspective.

Originality/value

This study will be valuable for services looking to develop and implement a similar service provision, in response to the need to tackle self-harm rates as a broader approach to suicide prevention. In light of the NHS long-term plan (2019), it also serves as an example of how to develop and use a strategic co-production group, and work collaboratively with the voluntary, community and social enterprise sectors.

Details

Journal of Public Mental Health, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1746-5729

Keywords

Click here to view access options
Article
Publication date: 5 January 2022

Cathy Brennan, Sonia Saraiva, Elizabeth Mitchell, Richard Melia, Lydia Campbell, Natalie King and Allan House

There are calls for greater regulation of online content related to self-harm and suicide, particularly that which is user-generated. However, the online space is a source…

Abstract

Purpose

There are calls for greater regulation of online content related to self-harm and suicide, particularly that which is user-generated. However, the online space is a source of support and advice, including an important sharing of experiences. This study aims to explore what it is about such online content, and how people interact with it, that may confer harm or offer benefit.

Design/methodology/approach

The authors undertook a systematic review of the published evidence, using customised searches up to February 2021 in seven databases. The authors included empirical research on the internet or online use and self-harm or suicide content that had been indexed since 2015. The authors undertook a theoretically driven narrative synthesis.

Findings

From 4,493 unique records, 87 met our inclusion criteria. The literature is rapidly expanding and not all the evidence is high quality, with very few longitudinal or intervention studies so little evidence to understand possible causal links. Very little content online is classifiable as explicitly harmful or definitively helpful, with responses varying by the individual and immediate context. The authors present a framework that seeks to represent the interplay in online use between the person, the medium, the content and the outcome.

Originality/value

This review highlights that content should not be considered separately to the person accessing it, so online safety means thinking about all users. Blanket removal or unthinking regulation may be more harmful than helpful. A focus on safe browsing is important and tools that limit time and diversify content would support this.

Details

Journal of Public Mental Health, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1746-5729

Keywords

Click here to view access options
Article
Publication date: 8 December 2021

Julia Anne Silano, Carla Treloar, Thomas Wright, Tracey Brown, Colette McGrath and Phillip Snoyman

This commentary aims to reveal how a steering committee has effectively responded to advancing accessibility to harm reduction resources, hepatitis C virus (HCV) policy…

Abstract

Purpose

This commentary aims to reveal how a steering committee has effectively responded to advancing accessibility to harm reduction resources, hepatitis C virus (HCV) policy and health strategies within adult prison settings in New South Wales (NSW).

Design/methodology/approach

By reviewing the audit approach taken by the of the Justice Health and Forensic Mental Health Network and Corrective Services New South Wales Harm Reduction Reference Group (JHFMHN/CSNSW HRRG), this commentary emphasizes the committee’s success in identifying contemporary harm reduction issues that affect people in custodial settings. This commentary is a compilation of data gathered through the 2018 JHFMHN/CSNSW HRRG audit and corresponding program materials. Conclusions regarding the effectiveness of the working group’s audit were drawn by critically appraising the JHFMHN/CSNSW HRRG’s Final Audit Report (JHFMHN and CSNSW, 2018) with reference to current harm reduction literature.

Findings

The HRRG has provided leadership, professional representation and strategic advice on the development, implementation, monitoring and evaluation of best practice harm reduction strategies in prison settings. The HRRG developed and maintained networks and information exchange between the state-wide HCV health network, corrections services and the NSW harm reduction sector at large. Public health partnerships and advocacy that involve all key players, such as the HRRG, will continue to be crucial to remove barriers to enhancing HCV harm reduction measures especially in NSW prison settings.

Social implications

Strategies such as primary prevention and treatment can mitigate the spread of HCV in the custodial system. This audit of access to harm reduction resources was conducted on behalf of the diverse group of professionals, scholars and stakeholders comprising the HRRG. This audit and other advocacy efforts of this committee can facilitate future access to quality healthcare and the necessary policies required to support a healthier prison population at large.

Originality/value

Collaborating with health authorities, researchers and social service workers can enable prison health-care systems to be guided by wider health workforce programs and public health standards. This collaboration can reduce the professional isolation of custodial health-care staff and promote a balanced approach to harm reduction policies by ensuring an equitable focus on both health and security imperatives.

Details

International Journal of Prisoner Health, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1744-9200

Keywords

Click here to view access options
Article
Publication date: 22 December 2021

Salim Mezaache, Laélia Briand-Madrid, Virginie Laporte, Daniela Rojas Castro, Patrizia Carrieri and Perrine Roux

People who inject drugs (PWID) face multiple health problems, including infectious diseases and drug overdoses. Applying syndemic and risk environment frameworks, this…

Abstract

Purpose

People who inject drugs (PWID) face multiple health problems, including infectious diseases and drug overdoses. Applying syndemic and risk environment frameworks, this paper aims to examine the co-occurrence and clustering of drug-related harms and their association with incarceration experience with or without in-prison drug injection.

Design/methodology/approach

The authors used data from a cross-sectional survey conducted in 2015 among 557 active opioid injectors. Self-reported data were collected through face-to-face or online questionnaires. They distinguished three harm categories, namely, viral infections, bacterial infections and overdoses, and built an index variable by summing the number of harm categories experienced, yielding a score from 0 to 3. Association between incarceration experience and co-occurrence of harms was modelled using a multinomial logistic regression.

Findings

Of the 557 participants, 30% reported lifetime experience of drug-related viral infection, 46% bacterial infection and 22% drug overdose. Multinomial logistic models showed that those who injected drugs during incarceration were more likely to report two (aOR = 2.35, 95% CI: 1.03–5.36) and three (aOR = 9.72, 95% CI: 3.23–29.22) harm categories than those who had never been incarcerated. They were also more likely to report three harm categories than formerly incarcerated respondents who did not inject drugs in prison (aOR = 5.14, 95% CI: 1.71–15.48).

Originality/value

This study provides insights of the syndemic nature of drug-related harms and highlights that drug injection during incarceration is associated with co-occurring harms. Public health interventions and policy changes are needed to limit the deleterious impact of prison on PWID.

Details

International Journal of Prisoner Health, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1744-9200

Keywords

Click here to view access options
Article
Publication date: 14 March 2016

Hans Wolff, Alejandra Casillas, Thomas Perneger, Patrick Heller, Diane Golay, Elisabeth Mouton, Patrick Bodenmann and Laurent Getaz

Prison institutional conditions affect risk for self-harm among detainees. In particular, prison overcrowding may increase the likelihood of self-harm by creating…

Abstract

Purpose

Prison institutional conditions affect risk for self-harm among detainees. In particular, prison overcrowding may increase the likelihood of self-harm by creating competition for resources, space, and enhancing a “deprivation state.” The purpose of this paper is to examine the association between overcrowding and prisoner acts of self-harm.

Design/methodology/approach

This cross-sectional study took place at Geneva’s pre-trial prison (capacity:376) between 2006 and 2014. Outcomes were acts of self-harm that required medical attention, and self-strangulation/hanging events (combined into one group, as these are difficult to differentiate). Dichotomous predictors were overcrowding index- annual mean daily population divided by capacity ( > 200 percent vs < 200 percent), and year group (2006-2009 vs 2011-2014).

Findings

Self-harm and self-strangulations/hangings increased in 2011-2014 compared to 2006-2010 (p < 0.001). Overcrowding in excess of 200 percent was associated with self-strangulation/hangings (p < 0.001) but not with all self-harm events. In terms of pertinent demographics that would affect self-harm, there was no prison change in gender, area of origin, foreign residency, religion, or psychiatric treatment.

Research limitations/implications

The present study is limited by the definition and identification of self-harm. The distinction between self-strangulation and self-hanging, and the precise classification of an intent to die is difficult to make in practice, especially with limited prison data records available. The relevant literature addresses the complexity of the association between non-suicidal and suicidal behavior. Despite this, the combined category self-strangulations/hangings gives some indication of severe self-harm events, especially since the methodology of categorization employed was consistent throughout the entire period of the study. Other limitations include the small sample size and the lack of individual patient data and prison data to help control for confounding factors. Despite these drawbacks, pertinent data (socio-demographics and number of prisoners treated for mental health and drug abuse) remained stable over the years. Thus, there are no apparent changes in the inmate population that could be linked to an increase in self-harm. High-security placements and mean prisoner stay have increased over time, with a decrease in staff to prisoner ratio – and these must be looked into further as contributors. Additionally, qualitative methods such as semi-structured interviews and focus groups could delineate the impact of overcrowding on prisoner well-being and self-harm potential.

Practical implications

The authors observed a significant increase in self-harm and self-strangulation/hangings over time, and overcrowding was significantly associated with self-strangulation/hangings (but not with all self-harm events). Overcrowding can impose destructive effects on the psychological and behavioral well being of inmates in prison, influencing a myriad of emotional and livelihood factors that predispose to harmful behavior.

Originality/value

This report should alert public health and prison authorities to this issue, and garner resources to address such an alarming rise. The findings from this short report demonstrate the need for a further examination of the mechanisms affecting self-harm among prisoners in this population, particularly the relationship between self-strangulations/hangings and overcrowding.

Details

International Journal of Prisoner Health, vol. 12 no. 1
Type: Research Article
ISSN: 1744-9200

Keywords

Click here to view access options
Article
Publication date: 19 September 2016

Marc Bush

The No Harm Done films provide hope and give support to those affected by self-harm. The accompanying digital packs dispel myths, answer frequently asked questions…

Downloads
158

Abstract

Purpose

The No Harm Done films provide hope and give support to those affected by self-harm. The accompanying digital packs dispel myths, answer frequently asked questions, provide practical advice and signpost to further help and support. The paper aims to discuss these issues.

Design/methodology/approach

YoungMinds employed its sector-leading expertise in youth and parent engagement. Both the films and digital packs were co-created with young people, parents and professionals, reflecting their real-life experiences of self-harm.

Findings

The project responded to young people who self-harm telling us they feel isolated, alone, in need of hope and help to counteract the negative and frightening messages widely available online. Parents confided they also feel isolated and that it is their fault their child is harming themselves. Teachers told us they see the signs but cannot bring themselves to say anything, and even if they want to, they cannot find the words to reach out to young people.

Originality/value

Quote from a professional “I personally found the No Harm Done short films to be incredibly valuable resources for my practice with young people. The way the films have been produced will make it a lot harder for young people that I work with to judge the action of self-harm given that there are no graphic harming words/stories and the films themselves do not come across as triggering. I feel enthusiastic that these films will encourage understanding and empathy from peers and spark conversation enabling those who have no knowledge around self-harm to be more accepting, open and supportive of those who have issues with self-harm.”

Details

Journal of Public Mental Health, vol. 15 no. 3
Type: Research Article
ISSN: 1746-5729

Keywords

Click here to view access options
Article
Publication date: 1 May 2005

Karen Gough

Previous research has established that guidelines to facilitate a non‐judgemental, consistent approach to self‐harm management would be useful to staff working in a…

Abstract

Previous research has established that guidelines to facilitate a non‐judgemental, consistent approach to self‐harm management would be useful to staff working in a forensic psychiatric setting. In the preparation of these guidelines, a literature search was conducted to examine the evidence on clinical effectiveness for managing self‐harm. Overall, the evidence for defining a definitive treatment approach to self‐harm is extremely limited. However, a number of studies/reviews have identified aspects of treatment and care that are considered to be effective. Guidelines have been produced that capitalise on this information and provide front‐line staff (such as nurses) with advice that can be used on a daily basis when working with a service user who self‐harms.

Details

The British Journal of Forensic Practice, vol. 7 no. 2
Type: Research Article
ISSN: 1463-6646

Click here to view access options
Article
Publication date: 1 December 2000

Karen Gough and Andrew Hawkins

Identified risk factors and clinical experience suggest that self‐harm is a common and very significant problem in forensic psychiatric settings. Sparse training on self…

Downloads
296

Abstract

Identified risk factors and clinical experience suggest that self‐harm is a common and very significant problem in forensic psychiatric settings. Sparse training on self‐harm given to staff throughout professional development is a concern for staff who can be left feeling dissatisfied and powerless as how to manage the patient who self‐harms. Consequently, staff often have to rely on idiosyncratic beliefs about self‐harm and its management to guide their practice. This survey investigated staff attitudes towards self‐harm in a forensic psychiatric service. The results highlight much variation in attitudes and a sub‐population of staff holding relatively more punitive/negative beliefs. In addition, the survey drew attention to the difficulty of managing self‐harm in forensic settings‐especially in relation to issues around facilitating safe self‐harm.

Details

The British Journal of Forensic Practice, vol. 2 no. 4
Type: Research Article
ISSN: 1463-6646

Click here to view access options
Article
Publication date: 24 November 2021

Gary R. Potter and Hattie Wells

This paper aims to consider the nature of cannabis-related harms under the UK’s Misuse of Drugs Act (MDA). Written for the specific context of this four-paper special…

Abstract

Purpose

This paper aims to consider the nature of cannabis-related harms under the UK’s Misuse of Drugs Act (MDA). Written for the specific context of this four-paper special section on 50 years of the MDA, it argues that the MDA may cause more harm than it prevents.

Design/methodology/approach

An opinion piece offering a structured overview of cannabis-related harms under prohibition. It summarises existing evidence of the ways in which prohibition may exacerbate existing – and create new – harms related to the production, distribution, use and control of cannabis.

Findings

The paper argues that prohibition of cannabis under the MDA may cause more harm than it prevents.

Originality/value

It has long been argued that the MDA does not accurately or fairly reflect the harms of the substances it prohibits, and much existing research points to different ways in which drug prohibition can itself be harmful. The originality of this paper lies in bringing together these arguments and developing a framework for analysing the contribution of prohibition to drug-related harm.

Details

Drugs and Alcohol Today, vol. 21 no. 4
Type: Research Article
ISSN: 1745-9265

Keywords

1 – 10 of over 32000