Search results

The purpose of this paper is to examine the current state of the literature on the variables associated with self-harm and aggression in women who committed a criminal offence.

Studies were identified through online databases, namely, PsycINFO, PubMed, ERIC and EBSCOhost, as well as manual searches of reference lists of the selected studies. The target population included women who committed a criminal offence and have engaged in self-harm and aggressive behaviors during their incarceration, either in correctional institutions or in forensic psychiatric settings.

Of the 1,178 studies identified, nine met inclusion criteria. The studies were conducted in six different countries and included data from 6360 female participants. Few studies examine self-harm and aggression in women who committed a criminal offence which speaks to the still sparse literature on this topic. This review of the association between self-harm and aggression in women offenders highlights the finding that a small group of women is often involved in both self-harm and aggression. The authors have identified possible psychological factors associated with women engaging in both self-harm and aggression. The findings also reveal a possible connection between types of aggressive behaviors and specific time periods during sentences or stays in forensic psychiatry.

The findings of this scoping review have clinical implications which may be considered by both researchers and the case management teams of women involved in both self-harm and aggression.

Despite the limited number of studies examining self-harm and aggression in women, this scoping review highlights gaps in the literature as well as notable psychological correlates of women who engage in self-harm and aggression.

The current review aims to focus on how risk and protective factors for self-harm in secure mental health hospitals are captured in the literature.

Fifty-seven articles were included in a systematic review, drawn from an initial 1,119 articles, post duplicate removal. Databases included Psycinfo, Psycarticles, Psycnet, Web of Science and EBSCO host. A thematic analysis was used, which included a meta-ethnographic approach for considering qualitative papers.

There was a clear focus on risk factors, with eight identified (in order of occurrence): raised emotional reactivity and poor emotion regulation; poor mental health; traumatic experiences; personality disorder diagnosis and associated traits; increased use of outward aggression – dual harm; constraints of a secure environment and lack of control; previous self-harm and suicide attempts; and hopelessness. Protective factors featured less, resulting in only three themes emerging (in order of occurrence): positive social support and communication; positive coping skills; and hope/positive outlook.

This includes a proposal to move focus away from “risk” factors, to incorporate “needs”, in terms of individual and environmental factors. There is also a need for more attention to focus on developing high quality research in this area.

The research captures an area where a synthesis of research has not been comprehensively undertaken, particularly with regards to capturing protective as well as risk factors.

High rates of suicide and self-harm are reported in prisons in Western countries, while fewer studies exist from a non-Western context. This study aims to identify rates of suicide, non-fatal suicide attempts and self-harm in Moroccan prisons and to better understand the context, methods, tools, predictors and profile of persons engaged in the acts.

The authors report findings from a mixed-methods study carried out before an intervention project. The study consists of a systematic literature review, an analysis of suicide case files, a quantitative survey on suicide attempts and self-harm, as well as interviews and focus group discussions. The authors calculate suicide, suicide attempt and self-harm rates and present descriptive data on the incidents. The authors use regression models to explore the association between the number of incidents per individual and selected predictors, adjusting for clustering by institution.

Over a four-year period, 29 detained persons in Morocco died by suicide (average annual suicide rate 8.7 per 100,000). Most were men under the age of 30. Hanging accounted for all but one case. In one year, 230 suicide attempts were reported. Over a three-months period, 110 self-harm cases were reported from 18 institutions, cutting being the most common method. Self-harm was significantly more prevalent among persons with a life sentence or repeated incarcerations.

To make the study manageable as part of an intervention project, the authors collected data on suicides and suicide attempts from all prisons, while data on self-harm were collected from fewer prisons and over a shorter time period. The authors did not collect comparable information from detained persons who did not die by suicide, attempt suicide or self-harm. This prevented comparative analyses. Further, it is possible that self-harm cases were not reported if they did not result in serious physical injury. Data were collected by prison staff; thus, the voice of incarcerated persons is absent.

This study provided a solid basis for designing an intervention project including the development of a national prison policy and guidelines on suicides, suicide attempts and self-harm and a country-wide training program for prison staff. It also led to a better surveillance system, allowing for trend analysis and better-informed policymaking. The qualitative results helped create an understanding of how staff may trivialize self-harm. This was integrated into the training package for staff, resulting in the creation of prison staff trainers who became the strongest advocates against the notion that self-harm was best ignored.

To the best of the authors’ knowledge, this is the first published data on suicide and self-harm in Moroccan prisons. It underscores the necessity for the intervention project and gives valuable insights into suicide and self-harm in a non-Western prison context. Further research is needed to assess whether the findings are typical of the region.

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.

Rates of self-harm are elevated in prison, and there is limited evidence to support the efficacy of brief risk screening at reception to predict and prevent self-harm. This study aims to examine the predictive validity of the self-harm/suicide screening items embedded in a prison mental health screening tool from two key domains strongly associated with risk: previous suicidal/self-harm behaviour, and recent ideation.

A sample of men and women were screened on entry to prison, with eight screening items covering the two key domains of risk. Follow-up data on self-harm incidents were collected for 12 months post-screening. The predictive validity of individual screening items, item combinations and cumulative screening score was examined for the overall sample and for men and women separately.

Individual screening items across the two domains were all strongly associated with self-harm in the follow-up period, with odds ratios varying from 2.34 to 9.24. The predictive validity of both individual items, item scores and item combinations demonstrated high specificity but low to moderate sensitivity, and modest area under the curves (AUCs). Predictive validity was generally better for men than women; however, differences were not statistically significant.

Identifying those at risk of self-harm in prisons remains challenging and brief universal screening at prison entry should be only one component of a broader prison risk assessment and management strategy.

To the best of the authors’ knowledge, this study is one of very few to prospectively examine self-harm behaviour following risk screening. Predictive validity was examined in a representative sample of individuals in custody, and for men and women separately.

Autism spectrum conditions (ASC) and borderline personality disorder (BPD) have overlapping symptom profiles. Dialectical behaviour therapy (DBT) is an established treatment for self-harm and BPD, but little research has investigated the outcomes of DBT for ASC populations. This exploratory service evaluation aims to investigate the outcomes of a comprehensive DBT programme for adolescents with a diagnosis of emerging BPD and a co-occurring ASC diagnosis as compared to those without an ASC diagnosis.

Differences from the start to end of treatment in the frequency of self-harming behaviours, BPD symptoms, emotion dysregulation, depression, anxiety, the number of A&E attendances and inpatient bed days, education and work status, and treatment non-completion rates were analysed for those with an ASC diagnosis, and compared between those with an ASC diagnosis and those without.

Significant medium to large reductions in self-harming behaviours, BPD symptoms, emotion dysregulation and inpatient bed days were found for those with an ASC diagnosis by the end of treatment. There were no significant differences between those with an ASC and those without in any outcome or in non-completion rates. These findings indicate that DBT may be a useful treatment model for those with an ASC diagnosis, though all results are preliminary and require replication.

To the best of the authors’ knowledge, this is the first study to report the outcomes of a comprehensive DBT programme for adolescents with an ASC diagnosis, and to compare the changes in outcomes between those with a diagnosis and those without.

Suicide and suicide-related incidents have increased within women’s prisons in the UK. This paper aims to synthesise the findings of qualitative literature, to gain a deeper understanding of the how women and staff in English prisons experience and explain the causes of their suicidal behaviours.

A systematic search of five electronic databases, namely, MEDLINE, APA Psychological Information Database (Psycinfo), Cumulative Index to Nursing and Allied Health Literature (with full text – CINAHL), Psychology and Behavioural Sciences Collection and APA PsycArticles, was completed in January 2023. This study’s search strategy returned 1,714 articles, 7 of which were included for review. To identify relevant themes within the data, Thomas and Harden’s (2008) framework was applied. Quality appraisal was conducted by using Joanna Briggs’ Institute Checklist for Qualitative Research (Joanna Briggs Institute, 2021).

Four themes were determined, which describe the causes of suicidal behaviours in women’s prisons in England; mental health and trauma, lack of support from services and staff, contact with family and self-harm as a coping strategy. Important sub-themes were also identified including the prison environment and poor relationships with staff.

Further qualitative research is needed, however, the findings suggest greater support is required to aid positive mental health, including the provision of trauma informed coping strategies and improved staff training.

To the best of the authors knowledge, this is the first systematic review conducted on the factors contributing to women’s suicide in English prisons using qualitative literature.

Remand prisoners (RPs) are known to be in a more vulnerable situation than those already convicted. Beyond the difficulties to adapt to the prison, RP also tend to experience tough circumstances due to the uncertainty of their future. This study aims to further test the psychometric properties of the Suicide Concerns for Offenders in the Prison Environment (SCOPE-2) in a sample of RP.

The authors have carried out a confirmatory factor analysis to test the psychometric qualities of the SCOPE-2. The authors tested the originally proposed two-factor structure composed of two subscales: optimism and protective self-worth. Also, the authors examined internal consistency through Cronbach’s alphas. Convergent validity was tested by correlational analyses between SCOPE-2 subscales and the Suicide Behaviors Questionnaire-Revised and Brief Symptom Inventory (BSI) total scores. Finally, the authors have tested known-groups validity by carrying out discriminant analysis by testing the SCOPE-2 subscales’ ability to predict belonging to a group with previous suicide attempts.

The confirmatory factor analysis showed an acceptable model fit, even though the subscale “Protective self-worth” presented a less acceptable fit. The correlation analysis supported the convergent validity of the SCOPE-2. Both the “Optimism” and “Protective self-worth” subscales showed a positive correlation with the total scores of BSI. Finally, the Portuguese version of SCOPE-2 also showed known groups validity. Concretely, the “Optimism” scores revealed an acceptable predictive accuracy.

This study embraces important contributions to the practice as it was the first study to validate a measure to assess vulnerability for suicide and self-harm in male and female RP.

To the best of the authors’ knowledge, this was the first study to validate an instrument to assess vulnerability for suicide and self-harm in both male and female pretrial detainees. Knowing their particular case, as well as the lack of responses for these individuals, it is particularly important to access suicide concerns that could precede suicide attempts.

This study aims to compare the impact of Australian onshore and offshore immigration detention centres (IDCs) on detainees’ health and health-care events.

It uses data extracted from the Australian Government’s quarterly health reports from 2014 to 2017. These reports contain a range of data about the health and well-being of detainees, including complaints/presenting symptoms and number of appointments and hospitalisations. To compare onshore and offshore data sets, the authors calculated the rate of health events per quarter against the estimated quarterly onshore and offshore detention population. They ran a series of two-proportion z-tests for each matched quarter to calculate median z- and p-values for all quarters. These were used as an indicator as to whether the observed differences between onshore and offshore events were statistically significant.

The results suggest that adults detained onshore and offshore have substantial health needs, however, almost all rates were far higher in offshore detention, with people more likely to raise a health-related complaint, access health services and be prescribed medications, often at two to three times the rate of those onshore.

This paper adds to a modest body of literature that explains the health of people detained in Australian IDCs. To the best of the authors’ knowledge, this is the first paper to explore health service utilisation and a range of other variables found in the Australian Government’s quarterly health reports. These findings bolster the evidence which suggests that detention, and particularly offshore detention is particularly harmful to health.

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.

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).

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.

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.