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Without exception, research on the contribution of the Prison Listener Scheme as a form of peer support for those who self-harm in custody has focussed on men in prison. Women’s experience of custody is shaped by their experiences of hegemonic masculinity that also mediate through women’s roles as mothers and caregivers. Women’s self-harm is similarly influenced by these gendered experiences. The purpose of this paper is to explore how the Listener Scheme as a form of peer-to-peer support for women contributes to women managing their self-harm in a female prison.

The paper used a case study design with a mixed-methods approach using a quantitative questionnaire with prison staff (n = 65) and women in custody who had self-harmed (n = 30). Qualitative methods included a focus group with Prison Listeners (n10) and semi-structured interviews with women who self-harm (n10) and prison staff (n10). Four days were also spent observing the prison environment.

Findings suggest that women seek support from other women as peer Listeners for three main reasons; their previous difficult experiences with men, a displacement of the mother role and their attachment needs in custody. Research suggests that women often have significant addictions and mental health concerns and are more likely than their male counterparts to engage in self-harm (Prison Reform Trust, 2017). In addition, women’s self-harm acts as a coping method for “intrapersonal issues” which documents self-harm as a result of frustration and lack of control in custody as opposed to “interpersonal issues” which documents self-harm as a result of relationship difficulties with partners (Walker et al., 2017). This paper suggests that peer support schemes internationally should be tailored to providing support for these types of gendered experience to support women who self-harm in custody. This has implications for the training and support of Listeners in women’s prisons.

This exploratory research was conducted in one female prison and while can be considered to test proof of concept is limited in its generalisability.

This paper suggests that Listeners providing peer-to-peer support for women in custody who self-harm may encounter triggers for this behaviour based on women’s experiences including; how women relate to men; women’s experience of the way custody displaces their role as mothers and women’s need for safe attachments in custody. These gendered experiences have implications for the training and development of peer support schemes in women’s prisons, such as the Listener scheme. Further research is needed to compare the gendered types of support Prison Listeners provide depending on whether they are in male or female prisons.

The purpose of this paper is to quantify the characteristics of dual-harm behaviour in prison in comparison with sole self-harm or assault behaviour in prison, with an analysis of the distinguishing features.

Official data on in-prison incidents, demographic and offending information were analysed for 326 prisoners in two prisons in England.

Proportions of up to 42 per cent of offenders who assault others in prison will also engage in self-harm and vice versa. Dual-harm prisoners will engage in a broader and greater frequency of prison incidents than either sole group; with dual-harm prisoners reflecting greater proportions of damage to property and fire-setting. There were no differences in their time in prison or presence of serious violent current conviction, however, an index offence of drug supply was less likely in the dual-harm group, with minor violence slightly more likely in longer sentence prisoners. There was no difference for the dual-harm prisoners whether the first incident was self-harm or violence, with mean duration from sole to dual harm of less than three months.

In-prison behaviour can assist in the identification of prisoners at dual risk of harm. Greater inclusion of in-prison behaviour and awareness of dual harm in research methodologies may assist in improving risk management. A wider use of joint risk assessment and single case management approach is suggested for prisoners with dual-harm profile.

This is the first study on dual-harm behaviour in UK prisons and to evaluate their wider prison behaviour and offending characteristics.

Peer and professional support are important for women in prison to help them tackle a range of issues including self-harm. To date, research has not explored in any depth how women experience peer support provided in prison to help them manage their self-harm including peer support provided through the Listeners Scheme. The paper aims to discuss these issues.

This was a case study in one women’s prison employing mixed, qualitative methods. These included a questionnaire distributed to women and staff, a focus group with prison listeners, semi-structured interviews with women who self-harmed and semi-structured interviews with prison staff, together with a series of observations in the prison site.

While women in prison welcomed both professional and peer support their support preferences were influenced by how serious women considered their self-harm to be and the degree to which they regarded their relationships with staff as trusting and/or supportive. The therapeutic community (TC) that operated in the prison facilitated different relationships between women who self-harmed in prison and staff, than have hitherto been reported in the research literature. These relationships described by women and staff as “more open” allowed women to seek staff support when managing their self-harm behaviours. Women sought peer support from listeners in addition to staff support particularly at times when staff were unavailable for example at evenings and weekends.

The case study design was conducted in one women’s prison which operated a TC. The principles of the TC that operated in the prison are supported by the wider literature on TCs as conducive to good mental health. Findings are thus relevant for establishments with TCs .

Women opted for support from staff for helping them to manage their severe self-harm, over and above the peer support available through the prison Listener Scheme. This finding contrasts with previous research that suggests women trying to manage their self-harm in prison prioritise support from their peers because staff are often found to harbour unhelpful attitudes to women’s self-harm that makes seeking support difficult.

The purpose of this paper is to examine the prevalence of suicide ideation amongst a group of people who had been arrested and taken into police custody, and were then referred to a mental health service operating in the police stations.

A referred sample of 888 cases were collected over an 18-month period during 2012/2013. Clinical assessments were conducted using a template in which background information was collected (including information about their previous clinical history, substance misuse, alleged offence, any pre-identified diagnoses, and the response of the service) as part of the standard operating procedure of the service. Data were analysed using a statistical software package.

In total, 16.2 per cent (n=144) reported suicide ideation, with women being more likely to report than men. In total, 82.6 per cent of the suicide ideation sample reported a history of self-harm or a suicide attempt. Suicide ideation was also associated with certain diagnostic categories (depression, post-traumatic stress disorder and personality disorder), a history of contact with mental health services, and recent (within 24 hours) consumption of alcohol or drugs.

This evaluation adds to the limited literature in this area by describing a large sample from a real clinical service. It provides information that can assist with future service designs and it offers support for calls for a standardised health screening process, better safety arrangements for those who have recently used alcohol or drugs (within 24 hours) and integrated service delivery across healthcare domains (i.e. physical healthcare, substance use, and mental health).

The purpose of this paper is to explore the role of trauma experience in pathways to self-harm or attempted suicide in female prisoners who died through self-inflicted death in England and Wales.

Quantitative study using the Prison and Probation Ombudsmen’s independent reports on deaths in custody. In total, 32 cases of female self-inflicted death in custody were coded on the presence of direct or interpersonal trauma, presence of superficial self-harm (SSH), near-lethal self-harm (NLSH), suicide attempts and recent significant life event. The number of previous suicide attempts (PSAs) and age at time of death was recorded.

Direct trauma is linked with repeated suicide attempts but recued the likelihood of SSH prior to suicide. Neither interpersonal trauma nor age increased likelihood of pre-suicide behaviours. NLSH was not predicted by either traumatic experience. Amongst these completed suicide cases, 56 per cent were not reported as having experienced trauma, 46 per cent had no recorded PSAs and 12 per cent also had no previous self-harm reported.

The small sample limited statistical power and specificity of classifications. Provides support for direct trauma in developing capacity for repeated suicidal behaviour as indicated in theoretical models of suicide (Joiner, 2005; O’Connor, 2011).

Different pathways to suicide likely to exist for female prisoners and importance of trauma intervention services.

Using cases of completed suicide in female prisoners to investigate the pathway to suicide from trauma through previous self-harm and attempted suicide.

Prison mental health in-reach teams (MHITs) have developed in England and Wales over the last decade. Services have been nationally reviewed, but detailed descriptions of their work have been scarce. The purpose of this paper is to describe the functions of one MHIT in a busy, ethnically diverse, male remand prison in London, UK.

Clinical and demographic data were collected for prisoners referred to the MHIT using a retrospective design over an 18-week period in 2008/2009 (n=111).

Foreign national prisoners and sentenced prisoners were significantly under-referred. Most referrals were already known to community mental health services, although around a quarter accessed services for the first time in prison. Around a third presented with self-harm/suicide risks. Substance misuse problems were common. Although the MHIT had evolved systems to promote service access, prisoner self-referrals were limited.

Foreign national prisoners require enhanced investment to improve service access. MHITs identify people with mental disorders for the first time in prisons, but better screening arrangements are needed across systems. An evaluation of multiple MHIT models could inform a wider delivery template.

One of the first ground-level evaluations of MHITs in England and Wales.

Rates of suicide in custodial settings continued to rise in the year 2013/2014. Consequently, the Division of Forensic Psychology funded training on “working with risk of suicide” which was delivered by Dr Slade at HMP Grendon. Due to the increasing prevalence of suicide in custodial settings, a review of this training was considered important to enhance professionals’ awareness of self-harm and suicide. The paper aims to discuss these issues.

The review begins with an introduction to the concepts of self-harm and suicide, and an introduction to where the training was held; HMP Grendon, a therapeutic community prison. The four key topics delivered by Dr Slade are then explored with regards to their aims and content. These topics include; the link between self-harm and suicide, why offenders harm themselves, assessment of suicide and finally, care planning. Residents of HMP Grendon also discussed their views of self-harm and suicide during the training day, these are thus explored within this review. Strength and weaknesses of the training were also explored, in addition to future practice considerations.

This review highlights the comprehensiveness of the training and its ability to engage the audience through discussions and activities. The collaboration between professionals and HMP Grendon residents to understand self-harm and suicide was also particularly noted.

This paper offers insight into the staff-resident collaboration at HMP Grendon and how training on self-harm and suicide can be delivered.