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Article
Publication date: 9 December 2011

James Ward and Di Bailey

People who self‐injure present a serious concern for many healthcare providers and no more so than for those working in the female prison estate. Despite the prevalence of…

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Abstract

Purpose

People who self‐injure present a serious concern for many healthcare providers and no more so than for those working in the female prison estate. Despite the prevalence of self‐injury and recent policy highlighting the need for staff training, misunderstanding and misinterpretation of self‐injury is rife within the healthcare professions often demonstrated by poor levels of service and care. This paper seeks to describe the development of a self‐injury training package for prison staff, through service user involvement, in order to address such deficits in care.

Design/methodology/approach

A participatory mixed methodological design engaged both staff and women in prison. Women offenders were involved in the development of training drawing upon their unique experiential expertise.

Findings

In total, 43 per cent of staff working directly with women recognised the need to develop their understanding of, and skills to manage, self‐injury. Key messages women wanted to convey to staff included how to communicate effectively and demonstrate empathy.

Research limitations/implications

Service user involvement in the training of staff is achievable in a prison environment. Women and prison staff identify the need for on‐going training in relation to the management of self‐injury. Limitations of the sampling strategies are acknowledged but not considered significant.

Practical implications

The authors assert that service user involvement is crucial in the development of meaningful training in the management of self‐injury.

Social implications

The involvement of service users in prison staff training empowers those involved and may foster improved prisoner‐staff relationships.

Originality/value

Service user involvement in prison staff training has no precedent in the UK.

Details

The Journal of Mental Health Training, Education and Practice, vol. 6 no. 4
Type: Research Article
ISSN: 1755-6228

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Article
Publication date: 2 August 2013

Alice Larissa Bennett and Mark Moss

The purpose of this paper is to explore client‐reported functions of deliberate self‐injury for prisoners located within a dangerous and severe personality disorder site.

Abstract

Purpose

The purpose of this paper is to explore client‐reported functions of deliberate self‐injury for prisoners located within a dangerous and severe personality disorder site.

Design/methodology/approach

As interviews produced in‐depth data indicating a very idiosyncratic experience of the function of deliberate self‐injury, interpretative phenomenological analysis was used within a small‐scale case study design.

Findings

Identified functions mirrored current quantitative research but few emerging themes were identified across the sample. Participants presented with varying levels of insight into their deliberate self‐injury.

Research limitations/implications

A small sample of young males was used within the study.

Originality/value

A “status‐seeking” function of deliberate self‐injury was also observed, which is not explicitly discussed within the current literature base. This study's findings can be of use to treatment providers for this population given their complex responsivity needs.

Details

The Journal of Forensic Practice, vol. 15 no. 3
Type: Research Article
ISSN: 2050-8794

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Article
Publication date: 23 April 2021

Vivienne de Vogel and Nienke Verstegen

Incidents of self-injury by forensic psychiatric patients often have a deleterious impact on all those involved. Moreover, self-injurious behaviour is an important…

Abstract

Purpose

Incidents of self-injury by forensic psychiatric patients often have a deleterious impact on all those involved. Moreover, self-injurious behaviour is an important predictor for violence towards others during treatment. The aim of this study is to analyse methods and severity of incidents of self-injury of patients admitted to forensic psychiatry, as well as the diagnoses of self-injuring patients.

Design/methodology/approach

All incidents of self-injury during treatment in a forensic psychiatric centre recorded between 2008 and 2019 were analysed and the severity was coded with the modified observed aggression scale+ (MOAS+).

Findings

In this period, 299 incidents of self-injury were recorded, displayed by 106 patients. Most of these incidents (87.6%) were classified as non-suicidal. Methods most often used were skin cutting with glass, broken plates, a razor or knife and swallowing dangerous objects or liquids. Ten patients died by suicide, almost all by suffocation with a rope or belt. The majority of the incidents was coded as severe or extreme with the MOAS+. Female patients were overrepresented and they caused on average three times more incidents than male patients.

Practical implications

More attention is warranted for self-injurious behaviour during forensic treatment considering the distressing consequences for both patients themselves, supervisors and witnesses. Adequate screening for risk of self-injurious behaviour could help to prevent this behaviour. Further research is needed in different forensic settings into predictors of self-injurious behaviour, more specifically, if there are distinct predictors for aggression to others versus to the self.

Originality/value

Incidents of self-injury occur with some regularity in forensic mental health care and are usually classified as severe. The impact of suicide (attempts) and incidents of self-injurious behaviour on all those involved can be enormous. More research is needed into the impact on all those involved, motivations, precipitants and functions of self-injurious behaviour and effective treatment of it.

Details

The Journal of Forensic Practice, vol. 23 no. 2
Type: Research Article
ISSN: 2050-8794

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Article
Publication date: 3 October 2017

Jennifer Barton, Steven R. Cumming, Anthony Samuels and Tanya Meade

Non-suicidal self-injury (NSSI) is distinguishable from suicide attempts (SAs) on a number of psychological and motivational factors. However, in corrective services…

Abstract

Purpose

Non-suicidal self-injury (NSSI) is distinguishable from suicide attempts (SAs) on a number of psychological and motivational factors. However, in corrective services settings, NSSI and SA are not clearly distinguished in assessment impacting on intervention. The purpose of this paper is to examine if any attributes differentiate lifetime history of SA+NSSI, NSSI and SA presentations in inmates who had recently been assessed in custody by a risk intervention team.

Design/methodology/approach

A comprehensive clinical assessment and file review was conducted with 87 male inmates (including a no self-injury control group) in two large correctional centres in New South Wales, Australia, to determine if three self-injury groups differ from the control group and if the three self-injury groups differ from each other across a range of static, trait, environmental and clinical characteristics.

Findings

The SA+NSSI group was most different from the control group (27/59 variables), and from the SA group (10/59 variables), predominantly across trait and clinical correlates. The SA group was least different from the control group (2/59 variables: suicide ideation, childhood physical abuse).

Originality/value

It was found that the presence of SA+NSSI history is an indicator of increased psychopathology. A history of SA only appears not readily associated with psychopathology. The self-injury subgroups reflected different clinical profiles with implications for risk assessment and treatment planning.

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Article
Publication date: 1 November 2002

Louisa Snow

This paper reports findings from a study of the social, situational and environmental factors that contribute to suicide and self‐injury in prison, focusing here on…

Abstract

This paper reports findings from a study of the social, situational and environmental factors that contribute to suicide and self‐injury in prison, focusing here on prisoners' motivations for their actions. In‐depth interviews were conducted with 143 prisoners in ten prisons in England and Wales who had engaged in an act of self‐injury or an attempt at suicide. The majority of participants described a number of precipitating or motivational factors related to concrete events, feelings/emotions (or both), operating within five different dimensions: offence‐related, interpersonal, symptom relief, instrumental and situational. In very few cases were there single reported causes. Motivational factors more prevalent among participants who attempted suicide included relationship problems, concerns about forthcoming court appearances and factors relating to drug withdrawal. Those who attempted suicide were more likely to describe concrete events or experiences as motivational factors. Those who injured themselves without suicidal intent were much more likely to describe negative feelings or emotions as precipitating factors. The results highlight the complex and multifactoral nature of suicidal and self‐injurious behaviours. At the very least they lend support to the suggestion that different strategies should be developed for those who attempt suicide and those who injure themselves for other reasons.

Details

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

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Article
Publication date: 10 May 2013

Kate Robertson, Sue Elcock, Chris Milburn, Phyllis Annesley, Jane Jones and Birgit A. Völlm

Patients in the National High Secure Healthcare Service for Women have a high prevalence of trauma and self injury. This highlights the need for specialised training of…

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Abstract

Purpose

Patients in the National High Secure Healthcare Service for Women have a high prevalence of trauma and self injury. This highlights the need for specialised training of staff dealing with such women. The aim of this study was to evaluate the trauma and self injury (TASI) training programme on staff knowledge and skills.

Design/methodology/approach

A total of 135 nurses and nursing assistants participated in the TASI two‐day training course. Questionnaires allowing for quantitative and qualitative data collection were completed before and after the training. Training and confidence levels in dealing with women who self‐harm prior to the training were identified and the impact of the programme was assessed.

Findings

The majority of staff had not received any previous training on trauma and self injury. There was an increased level of confidence in working with trauma and self injury following training and staff reported an increased ability to ask for support. Self‐perceived competence improved to a greater extent in those who had not received previous training compared to those who had.

Research limitations/implications

The authors' data is limited to self‐report. Future research should use objective measures to evaluate the impact of staff training.

Practical implications

A relatively short training programme focusing on trauma and self injury appears to improve staff confidence, understanding and competence in working with women patients in a high secure setting. Similar training programmes might also be beneficial in different patient groups with complex backgrounds and behaviours.

Originality/value

This is the first report on a training programme focussing on women in high secure care who self‐harm and have experienced trauma.

Details

The Journal of Forensic Practice, vol. 15 no. 2
Type: Research Article
ISSN: 2050-8794

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Article
Publication date: 1 January 1999

Glynis Murphy

Self‐injurious behaviour can become an intransigent difficulty, reduce people's quality of life and lead to hospital admissions or other restrictive outcomes (such as the…

Abstract

Self‐injurious behaviour can become an intransigent difficulty, reduce people's quality of life and lead to hospital admissions or other restrictive outcomes (such as the wearing of protective devices to prevent serious injury). Over the last 15 years there have been some important developments in the treatment of severe self‐injury, but the evidence is that these are making little impact on most people's lives. The reasons why this might be are discussed, and it is proposed that it is time for a radical new approach to interventions for self‐injurious behaviour.

Details

Tizard Learning Disability Review, vol. 4 no. 1
Type: Research Article
ISSN: 1359-5474

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Article
Publication date: 17 February 2021

Nicole Gray, Penelope Hasking and Mark E. Boyes

Non-suicidal self-injury (NSSI) is a growing public health concern. Continued NSSI is often associated with negative outcomes, yet the behaviour usually serves a purpose…

Abstract

Purpose

Non-suicidal self-injury (NSSI) is a growing public health concern. Continued NSSI is often associated with negative outcomes, yet the behaviour usually serves a purpose for individuals who self-injure (e.g. emotional relief). As such, individuals who self-injure often experience ambivalence about the behaviour. The purpose of this paper is to highlight the importance of recognising ambivalence as a natural and expected part of the recovery process.

Design/methodology/approach

This paper draws on literature regarding NSSI recovery, ambivalence towards stopping the behaviour and challenges for both clients and health professionals.

Findings

This paper argues that ambivalence towards self-injury can be challenging for both clients and health professionals. Clients may feel shame and sense of failure if they experience a setback; health professionals may experience frustration towards clients who continue to self-injure despite treatment.

Originality/value

Validation of the clients’ experience can have significant positive outcomes in treatment and help-seeking behaviours. Acknowledgement of client ambivalence during the recovery process will serve to validate clients’ experience and facilitate rapport. Health professionals who accept ambivalence as a natural part of the recovery process may experience less frustration with clients who continue to self-injure.

Details

Journal of Public Mental Health, vol. 20 no. 4
Type: Research Article
ISSN: 1746-5729

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Article
Publication date: 31 January 2011

Pauline Heslop

This article reports on support that people with learning disabilities who self‐injure say they have found, or would find, helpful in relation to their self‐injury. It is…

Abstract

This article reports on support that people with learning disabilities who self‐injure say they have found, or would find, helpful in relation to their self‐injury. It is an important issue, because most interventions and approaches are based on past patterns of support or what professionals think is helpful or appropriate. Rarely has the voice of the person concerned been heard. The clear message from people with learning disabilities, including those who use little or no verbal communication, is that they want opportunities to communicate their feelings and to be listened to. Being open to listening and developing one's own communication skills is essential for supporters of people with learning disabilities who self‐injure.

Details

Tizard Learning Disability Review, vol. 16 no. 1
Type: Research Article
ISSN: 1359-5474

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Article
Publication date: 28 February 2019

Phyllis Annesley, Adedayo Alabi and Laura Longdon

The purpose of this paper is to describe the Eye movement desensitisation and reprocessing (EMDR) treatment of an adult female patient detained within a high secure…

Abstract

Purpose

The purpose of this paper is to describe the Eye movement desensitisation and reprocessing (EMDR) treatment of an adult female patient detained within a high secure hospital with complex mental health difficulties, including complex trauma, factitious disorder, self-injury and a history of offending. The EMDR treatment addressed the patient’s urges to engage in severe and sometimes life-threatening self-injury, a primary motive of which was to access physical healthcare interventions within a general hospital. The paper describes the wide-ranging benefits of the treatment and incorporates feedback from the patient and clinicians within her multi-disciplinary team (MDT).

Design/methodology/approach

Four triggers for self-injury were processed during the therapy using the DeTUR Protocol (Popky, 2005, 2009) and the Constant Installation of Present Orientation and Safety (CIPOS, Knipe, 2009a) method. In total, 18 one hour therapy sessions were delivered plus three follow-up sessions to continue to offer support and complete the post-treatment evaluation.

Findings

The level of urge for each trigger was reduced to 0 which the patient defined as “no urge to self-injure”. Benefits went well beyond self-injury with reported positive impacts on mood, thinking, sleep, concentration, memory and experience of flashbacks.

Practical implications

This case report demonstrates that the EMDR DeTUR Protocol together with the CIPOS method can be extremely valuable in the treatment of patients who self-injure.

Originality/value

The case report offers an important contribution to an area that requires much further research.

Details

Journal of Criminological Research, Policy and Practice, vol. 5 no. 1
Type: Research Article
ISSN: 2056-3841

Keywords

1 – 10 of 417