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Internationally, rates of suicide and lifetime self-harm are higher in prisoners compared to the general population. This study aims to identify specific characteristics of self-harming behaviour and to establish a profile of prisoners who engage in self-harm.

Data from the Self-Harm Assessment and Data Analysis Project (SADA) on self-harm episodes in prisons in the Republic of Ireland during 2017–2019 was used. Annual rates per 1,000 were calculated by age and gender.

The rate of self-harm between 2017 and 2019 was 31 per 1,000 prisoners for men and six times higher at 184 per 1,000 prisoners for women. The rate of self-harm was twice as high among prisoners on remand than sentenced prisoners (60.5 versus 31.3 per 1,000). The highest rates of self-harm among sentenced prisoners were observed among 18–29-year-old men (45 per 1,000) and women (125 per 1,000). The rate of self-harm was higher among women prisoners in all age groups. Contributory factors associated with self-harm were mainly related to mental health but also linked to a prisoner’s environment and relationships.

There is a need to ensure access to timely and suitable mental health services, including both appropriate referral and provision of evidence-based mental health interventions to address the needs of these cohorts.

To the best of the authors’ knowledge, this is the first national study to systematically examine incidence and patterns of self-harm among the prison population in Ireland. The recording of severity/intent of each episode is novel when assessing self-harm among the prison population.

The purpose of this paper is to understand the needs and motivations of incarcerated men who self-harm with no apparent suicidal intent. These have received little attention in research and policy, despite men accounting for a high and increasing proportion of self-harm in prisons.

Semi-structured interviews were conducted with 20 adult male prisoners with a recent history or thoughts of non-suicidal self-harm. The interviews were analysed drawing on principles of thematic analysis and discourse analysis.

Against a backdrop of early traumatic experiences and more recent adverse events (including prison-related ones), self-harm was described by many as a desperate – but meaningful – coping strategy; both a means of releasing tension, sadness and frustration, and of being heard in an unresponsive system.

These findings echo those of research conducted with women (including women prisoners) who self-harm, but challenge some of the more negative ways in which non-suicidal male prisoner self-harm has been portrayed in the (scant) previous literature. As well as pointing to the need for greater awareness of the complex needs of men in prisons, they underscore the importance of (also) exploring – and perhaps addressing – the issue of self-harm separately from suicide, and of striving to make prisons, as well as prisoners, “healthier” and better able to cope with pressure.

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.

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).

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.

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.

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.

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.

Research has consistently shown that staff working with people who self‐harm tend to experience a range of anxieties and negative emotions. Very little has been written on the particular issues and needs of staff in prisons, where rates of self‐harm are high. The current study gathered information about existing sources of support for staff dealing with prisoners who self‐harm, and identified positive practice examples. A postal survey was sent out to the Suicide Prevention Team Leaders from every HM Prison Service Establishment in England and Wales (139 in total). Fifty‐four surveys (38.8%) were completed and returned. Findings indicate that staff support services were reportedly in place in virtually all 54 establishments. However, the data suggest that even when present, provisions may not have adequately met the needs of staff working with prisoners who self‐harm, particularly when dealing with ‘repetitive’ self‐harming behaviours. These findings are discussed in relation to organizational health literature. Their practical and theoretical implications are considered, together with directions for further studies in this under‐researched area.

The purpose of this paper is to report on the internal consistency, convergent validity and test-retest reliability of the Attitudes to Prisoners who Self-Harm scale (APSH). The latter have yet to be examined.

Participants were prison staff with prisoner contact (N=97). Internal consistency of the APSH was examined using Cronbach’s α. Convergent validity of the APSH was examined by comparing it to the Self-Harm Antipathy Scale, a reliable and valid measure of healthcare staff attitudes to self-harm. Test-retest reliability was examined by re-administering the APSH one week after initial assessment (n=75).

The measure demonstrated adequate levels of internal consistency, convergent validity and test-retest reliability.

The findings support use of the APSH within custodial settings. It could be used to guide recruitment and training of prison officers that care for prisoners who self-harm and to evaluate the efficacy of their training. This would influence good practice.

The purpose of this paper is to explore the experiences of prison staff working with imprisoned women who self-harm in English prisons. In this small-scale study, 14 prison staff in three English prisons were interviewed to examine the strategies currently used by them to support imprisoned women who self-harm.

Thematic analysis (Braun and Clarke, 2006) was used to identify three key themes: “developing a relationship”, “self-help strategies” and “relational interventions”.

Many staff expressed some dissatisfaction in the techniques available to support the women, and felt their utility can be restricted by the prison regime.

This study suggests that there is currently a deficit in the provision of training and support for prison staff, who are expected to fulfil a dual role as both custodian and carer of imprisoned women. Further research into prison staff’s perception of the training currently available could highlight gaps between current theory and practice in the management of self-harm and thus indicate content for future training programmes. Research exploring the impact of working with imprisoned women who self-harm is suggested to identify strategies for supporting staff. It must be acknowledged that this is a small-scale qualitative study and the findings are from only three prisons and may not apply to staff in other settings.

Currently few studies have focussed on the perspective of prison staff. This study is one of very few studies which focusses on the techniques and resources available to support the women, from the perspective of the prison staff.

This article reviews the international literature of the last two decades on self‐injurious behaviour in prisons and jails and introduces the risk factors associated with this behaviour. Studies from a variety of countries investigated different samples (e.g. in jails or prisons; female or male inmates). We only chose those studies using a control group of inmates without self‐injurious behaviour. The findings on potential risk factors for self‐injurious behaviour are largely contradictory because of the differences in sample selection and dependent variables (deliberate self‐harm without suicidal intent vs. suicide attempts). We also discuss some methodological problems in predicting self‐injurious behaviour.

Rates for self‐inflicted deaths (SIDs) were analysed in English and Welsh prisons. Whilst the overall reductions in SIDs are to be welcomed, the data demonstrate that there is variation in progress with SIDs reduction across the different types of prison. SIDs is increasing in high security prisons and these findings have implications for both research and commissioning. Those that commission prison mental health services in primary care trusts must recognise the need for targeted interventions that acknowledge three major issues indicated in the literature: the likely childhood trauma experienced by mentally disordered prisoners; a better recognition of the important role played by victimisation and intimidation in SIDs; and greater investment in alcohol treatment programmes in prison. Research should be commissioned that examines these factors in relation to SID.

The purpose of this paper is to examine the predictors of self-harm in male inmates.

Male inmates with and without a background of self-harm (i.e. suicidal and non-suicidal) were compared across two distal (static and trait) and two proximal (environmental and current/state psychological) domains. The factors from the four domains which may accurately classify self-harm history were also examined.

The two groups were significantly different across the four domains, particularly on psychological characteristics. The self-harm group was associated with childhood trauma, violent offences, institutional misconducts and lower levels of social support significantly more than the non-self-harm group. Being single, childhood abuse, impulsivity, antisocial personality disorder and global psychopathology were the five key predictors that contributed to 87.4 per cent of all cases being correctly classified.

The high levels of psychiatric morbidity and childhood trauma in the self-harm group indicated a need for interventions that address emotional and interpersonal difficulties and optimization of adaptive coping skills. Also, interventions may require a focus on the behavioural functions.

A novel approach was taken to the grouping of the variables. A comprehensive range of variables, was assessed simultaneously, including some not previously considered indicators, and in an understudied population, Australian male inmates. The lower levels of agreeableness, conscientiousness and generalized anxiety disorder which distinguished the self-harm and non-self-harm group, were newly identified for self-harm.