Attitudes of Female Warders towards inmate who self-harm: A pilot Exploratory Study from an Inner-city Prison in South India

Self-harm is a global public health challenge. The management and treatment of those who self-harm is emotionally challenging, and can sometimes manifest in negative attitudes amongst staff who provide care. Health professional’s attitudes towards deliberate self-harm have been studied globally, however, evidence regarding prison staff attitudes is sparse, and particularly lacking in India. The primary aim of this study was to explore the attitudes of female prison warders towards prison inmates who self-harm in an Indian setting. A cross-sectional survey using a questionnaire to measure knowledge and attitudes was administered to prison warders from one city prison in South India. Out of the 210 approached to participate, 170 female warders completed the survey questionnaire. In general, sociodemographic factors of the prison warders were unrelated to their attitudes towards self-harm, and a negligible few had received any training specific to self-harm. A series of educational and skills recommendations have been developed from the study, which can be used to inform intervention initiatives and further, provide a basis for cross-cultural professional comparison studies. Current resources, cultures, practice and context must be considered in any future interventions aimed at progressing the evidence base further. In addition, training and education for staff should include information on knowledge and attitudes about causes, reasons, motivations, forms and purpose of self-harm. Records of staff responses to those who self-harm, irrespective of setting, should include assessment, management, interventions undertaken and incorporated daily practice. Importantly, this work may influence prisoner treatment outcomes and is worthy of further study