Self-harm in a men's prison: staff's and prisoners' perspectives.

This thesis draws on feminist and critical phenomenological perspectives to explore the issue of self-harm in men's prisons. In relation to what remains a "hidden problem" (Howard League, 1999, p. 1), the needs of men harming themselves with no apparent suicidal intent have been particularly overlooked, as have those of staff dealing with this complex behaviour. In-depth interviews with 20 adult male prisoners and 38 members of staff explored participants' experiences, views and concerns in relation to repetitive, non-suicidal self-harm. A pluralistic methodological approach, drawing on the principles of thematic and discourse analysis, informed the analysis of interview data, to reveal dominant themes, as well as tensions, inconsistencies and possibilities for change. As shown by previous studies, the notion of non-suicidal self-harm as "attention seeking" was a recurrent theme amongst staff, especially officers, doctors and nurses. This was situated within multiple, and at times overlapping, discourses, including 'medication seeking', 'poor coping' and 'cry for help' themes. In many accounts, less stigmatising discourses also existed, but were applied to specific types of 'self-harmers' (often a minority) in a rigid and hierarchical manner. Interviews with specialists and prisoners challenged this "stereotypical view", re-positioning men who self-harm as 'victims' and/or 'survivors' of their "imported vulnerability" (Liebling, 1995), and of the "pains of imprisonment" (Sykes, 1958). Amongst the latter, difficult relations with staff, and negative reactions to self-harm, were reported to have important implications for prisoners and their self-harming behaviours. Locating these responses within the context of staffs roles and occupational cultures helped to further understand and deconstruct the sorts of reactions that prisoners identified as "dangerous" and dehumanising, and also brought attention to their possible functions and effects for staff themselves. The wider context of work also provided a useful focus to consider how negative staff reactions to self-harm may be addressed. Eliciting staffs views and preferences for training, support and supervision revealed some of the tensions in supporting staff – and prisoners - in an under-resourced and over-crowded environment, and where a 'macho' form of managerialism, and actuarial conceptualisations of 'care', arguably hinder the welfare of both prisoners and staff. The thesis concludes by reflecting on these findings, the ways in which they were produced, and their wider implications for future policy and research

If I am woman, who are 'they'? The construction of 'other' feminisms

Characterizations of feminist identities are presented, represented and, arguably, misrepresented within current public debates and popular media. Issues of sameness and difference have come to the fore as both timely and politically relevant. This paper aims to address issues arising from engagement with feminisms, in particular those which we experience as 'other' but which, concurrently, resonate with many of our concerns. Conflicting views revolve around the viability of constructing stable political identities for women who elect to include the term 'feminist' in their selfdescription. These debates become increasingly complex when contextualized within relative power positionings of knowledge production in differing arenas. Drawing on the literature around the legitimization of gender and political identities, the authors reflect in this paper on the possibilities of engaging with these identities, both in our capacity of 'others', but also as individuals whose theoretical positioning resonates with the issues under consideration

Exposure to and experience of self-harm and self-harm related content: an exploratory network analysis

Exposure to the self-harm behaviour of others plays a role in individuals’ own self-harm thoughts and behaviours, but there has been little consideration of the broader range of mediums through which exposure to self-harm related content may occur. N = 477 participants completed an online study, including questions regarding lifetime history of self- harm thoughts and behaviours and the frequency with which they had been exposed to self- harm via various mediums. Gaussian Markov random field network models were estimated using graphical LASSO and extended Bayesian information criterion. Bootstrapping revealed that exposure mediums with a direct connection to self-harm thoughts and behaviours were the internet (rrp = .34, 95% CI [.26, .42]) and in-passing ‘miscellaneous’ exposure (rrp = .14, 95% CI [.00, .23]). However, stability of the network centrality was low (expected influence stability = 0.52). The node with the greatest increase in expected influence within the network was miscellaneous “in-passing” exposure. In-passing exposure is an understudied exposure medium. Our results may suggest new types of exposure mediums for future research. Data were cross-sectional, so temporal relationships between exposure and behaviour could not be determined. Low stability of the networks suggests that future similar studies would benefit from larger sample sizes

Non-suicidal self-harm amongst incarcerated men: a qualitative study

Purpose: To further understanding of 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. Methods: 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. Findings: 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. Value: 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

Mother-infant separations in prison. A systematic attachment-focused policy review

Mothers in prison separated from their young children are an overlooked group. Attachment theory could provide a useful model to underpin interventions and better support women affected by separation from their infants. Current policy draws on a limited body of evidence and research has developed considerably since its first design. This review systematically searched all relevant UK prison policy and government documents with regards to mother and child separation in prison and analysed the extent to which these documents draw on attachment theory. Following initial searches, 58 documents were thematically analysed. Attachment was implicitly referred to in most documents but only explicitly mentioned in four. Global themes identified included ‘separation as trauma’. However, document groups varied in focusing either on the mother or the child and there were no joint perspectives. Developing and researching specific attachment-informed interventions might be one way forward as would further attachment-based research in this area

Suicide on the railways in Great Britain: a multi-disciplinary analysis

As part of wider efforts to reduce suicide on the railways, Network Rail commissioned a programme of research and consultation focusing on railway suicide messaging and communications. The aim of this work was to generate new multi-disciplinary insights and actionable intelligence for the rail industry. The secondary analysis of existing interview and survey data , taken alongside the analysis of online environments , previous ethnographic and anthropological work , and consultations with academic, rail industry and lived experience experts, has enabled us to generate a fairly full and clear picture of how people who are contemplating (or who have contemplated and attempted) suicide on the railways engage with and express the idea of railway suicide, and the types of associations made about that method / location. In short, by bringing together the findings from different studies, and looking for overlaps, common themes, as well as differences, we have been able to develop a good sense of the cultural scripts and discourses that together form ‘railway suicide’ as a knowable and available means of ending one’s life. More specifically, from these sources we have been able to draw out the factors that seemingly attract people to the method/location (quick, lethal, accessible, commonly used method), and also what dissuades them (impact on others - especially the driver, possibility of surviving with injuries, possibility of intervention, fear-inducing method). The logic, in terms of a messaging / communications strategy, would therefore be to challenge the ‘attractors’ (because many are misunderstandings or myths) and try to reinforce or amplify the ‘dissuaders’. There are complexities and difficulties to be considered, though, particularly around risks, possible unintended consequences, and the nuances needed to communicate to different audiences

‘Overwhelmed and powerless’: Staff perspectives on mother-infant separations in English prisons

Imprisoned mothers are at increased risk for poor psychological health and psychological distress when separated from their children, so staff need to be highly skilled to support the women. However, there is a paucity of research focusing on staff experiences around sensitive issues such as mother-child separation. This study aimed to understand the challenges facing staff and how these might be addressed. This qualitative interview study explored the views and experiences of 24 prison-based staff in England working with female prisoners separated from their infants. Staff emphasised the challenges of working with separated mothers, specifically the emotional impact of this work, and the impact of the wider criminal justice system on their sense of agency. A focus on the experience of separation highlights the broader problem of incarcerating women in general. Reducing the number of mother-child separations would mitigate the impact on both women and staff

Mother-infant separations in prison. A systematic attachment-focused review of the academic and grey literature

This review systematically searched UK academic and grey literature in relation to mother and child separation in prison. Attachment theory is referred to in current prison policy for mothers (PSO 4801, 2008), and could provide a framework linking policy and practice. Reviewing grey literature provided an opportunity to explore practice-based literature. 24 academic papers and 51 grey documents were reviewed. Use of attachment theory in the academic literature varied according to discipline, ranging from extensive use to no use. There was greater use of attachment theory in the grey literature. Despite linguistic differences, all documents highlighted the detrimental impact of separation on imprisoned mothers. However, specificity was lacking regarding support for mothers, and staff needs were overlooked. Given its use across the sparse research and practice literature, and its basis for policy, attachment theory could underpin theoretically informed support for imprisoned mothers separated from their infants and staff who support them

Quality traceability for user-centric context-aware systems in intelligent environments

Context-awareness is an important component of modern software systems. For example, in Ambient Assisted Living (AAL), the concept of context-awareness empowers users by reducing their dependence on others. Due to this role in healthcare, such systems need to be reliable and usable by their intended users. Our research addresses the development, testing and validation of context-aware systems in an emerging field which currently lacks sufficient systems engineering processes and disciplines. One specific issue being that developers often focus on delivering a system that works at some level, rather than engineering a system that meets a specified set of system requirements and their corresponding qualities. Our research aims to contribute towards improving the delivery of system quality by tracing, developing and linking systems development data for requirements, contexts including sensors, test cases and their results, and user validation tests and their results. We refer to this approach as the “quality traceability of context-aware systems”. In order to support the developer, the quality traceability of context-aware systems introduces a systems development approach tailored to context-aware systems in intelligent environments, an automated system testing tool and system validation process. We have implemented a case study to inform the research. The case study is in healthcare and based on an AAL system used to remotely monitor and manage, in real time, an individual prone to depressive symptoms