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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.

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.

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.

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.

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.”

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.

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.

Can one describe the ‘natural’ process of pregnancy as ‘harm’, even when negligently brought about? What does that harm consist of? Offering a contextual analysis of the English judiciary's characterisation of wrongful pregnancy, this paper demonstrates from a feminist perspective that the current construction of pregnancy as a ‘personal injury’ is deeply problematic. Forwarding an alternative account, this paper argues for law to embrace a richer notion of autonomy that will better resonate with women's diverse experiences of reproduction, and articulate the importance of autonomy in the reproductive domain: notably, women gaining control over their moral, relational and social lives.

Previous research has found that people who use anabolic androgenic steroids (hereafter ‘steroids’) typically describe these drugs as safe. However, research exploring the inside perspective on steroid risk has focussed on steroids in general, and failed to examine how particular steroids are viewed and experienced. During my online ethnographic research in bodybuilding communities, I found discussion of one particular steroid said to cause significant physical, psychological, social and sexual harm: trenbolone. Trenbolone is a veterinary drug used to increase muscle in beef cattle that has been found to have neurodegenerative and genotoxic effects on animals. It has been used by bodybuilders since the 1980s, and recent research has found it to be one of the most popular steroids used by bodybuilders. If trenbolone is described by bodybuilders as causing significant harm, why do so many bodybuilders use it? This chapter attempts to answer this question through a description of bodybuilder folk models of trenbolone risk. Using a social life of drugs approach it describes: (1) the effects of trenbolone; (2) how these effects are given meaning as either harms or benefits, and then weighed against each other; (3) how the risks of trenbolone are reduced through harm reduction strategies and (4) the role of online communities in negotiations of trenbolone risk. Trenbolone was found to occupy a mythical status in bodybuilding communities, in part because of the conflicted relationship bodybuilders have with the drug. This conflicted relationship illustrates the inherent ambivalence of drugs, which are always both remedy and poison.

With digital spaces an increasing feature of our everyday lives, and the internet now a primary means of sourcing IPEDs and information regarding their use, this chapter seeks to understand how digital fitness forum communities shape the dissemination of culturally embedded harm reduction advice. Findings are drawn from two netnographic studies of fitness forums, which identify several key areas in which community norms and structures served to inform harm reduction behaviours. This included embedded forum reputation systems and the ways in which these shaped IPED access, including through elevating ‘expert’ users and encouraging informed discussion regarding product quality, to the emergence of steroid testing services from forums as a community harm reduction tool. Second, forums were observed to often encourage users to conduct research and inform themselves regarding safe use, though limitations to this norm were also documented in relation to poor-quality medical advice, highlighting the issues with IPED users' reliance on anecdotal advice in the contexts of prohibition. Finally, the role of digital fitness forums as ‘digital backstage’ is considered, examining both how this can be harmful to IPED users from excluded or ‘otherised’ groups, but simultaneously offers cultural participants the opportunity for airing vulnerabilities in a space where their masculine identity is not threatened in doing so, thus facilitating harm reduction among cultural ‘insiders’.

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.

Moral intensity is the degree of feeling we have about the consequences of moral choices, similar, for example, to those perceived for crimes, from petty larceny to murder. Moral intensity is thought to increase moral sensitivity and judgment. Because the accounting professions require members to respond to accounting fraud with more sensitivity and intensity, we examine this response in 220 professional accountants (mostly Certified Public Accountants) under a controlled experiment using two different cases. We examine the first three parts of the Rest (1986) model including ethical evaluation, judgment, and intention to act. We measure moral intensity in the accountant’s perception of overall harm and societal pressure. As in prior research, we find that the degree of moral intensity may be contextual. We find that the ethical evaluations may become affected by perceived overall harm, and whistleblowing intentions by perceived societal pressure. However, in both cases, the professional’s judgments are most affected by moral intensity. Consistent with prior research, whistleblowing intentions may involve many other mitigating variables, such as audit reporting or non-audit reporting limited by codes of conduct. These findings relate to the increasing attention paid by the SEC to finding accounting fraud.

This manuscript makes three important contributions to the existing literature. First, there are few studies in this area and Jones (1991) identifies that moral intensity is issue contingent; therefore, replication studies using different scenarios are needed. Second, Bailey, Scott, and Thoma (2010) have suggested that accounting ethics research has focused too narrowly on Component II of Rest’s Four-Component Model. None of the previous studies looked at all three steps in Rest’s Model; therefore, our manuscript provides an important contribution over the other previous studies. Third, our sample uses professionals and not students as surrogates for professionals.

The ideal of an open, all-inclusive, and participatory internet has been undermined by the rise of gender-based and misogynistic abuse on social media platforms. Limited progress has been made at supranational and national levels in addressing this issue, and where steps have been taken to combat online violence against women (OVAW), they are typically limited to legislative developments addressing image-based sexual abuse. As such, harms associated with image-based abuse have gained recognition in law while harms caused by text-based abuse (TBA) have not been conceptualized in an equivalent manner.

This chapter critically outlines the lack of judicial consideration given to online harms in British courts, identifying a range of harms arising from TBAs which currently are not recognized by the criminal justice system. We refer to non-traditional harms recognized in cases heard before the British courts, assessing these in light of traditionally recognized harms in established legal authorities. This chapter emphasizes the connection between the harms suffered and the recognition of impact on the victims, demonstrated through specific case studies. Through this assessment, this chapter advocates for greater recognition of online harms within the legal system – especially those which take the forms of misogynistic and/or gendered TBA.