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

Sounding out d/Deafness: The experiences of d/Deaf prisoners

Purpose: The purpose of this paper is to provide an insight into the lived realities of d/Deaf prisoners in England and Wales, and to explore previous claims that they suffer disproportionately during their time in custody. Design/Methodology/Approach: For the purposes of this study a qualitative approach was taken. As part of this, 28 semi-structured interviews were carried out at seven adult male prisons in England with a sample of male hard of hearing/d/Deaf prisoners, and staff members who had worked with them. The interviews were recorded using a Dictaphone, and then transcribed as close to verbatim as possible. From this the transcriptions were analysed using thematic analysis. In addition to interviews, observations were made at each establishment, and later recorded in a fieldwork journal. Findings: Findings from the study showed that the way a d/Deaf person experiences prison depends strongly on the way in which they identify with their d/Deafness. However, it was also shown that there is little room for either deafness or Deafness in prison, with severely deaf and culturally and linguistically Deaf prisoners commonly experiencing the pains of imprisonment more severely than their hearing peers as a result the Prison Service's inability to accommodate such difference. Originality/Value: This study fused together the fields of Deaf Studies and prison studies in a way that had not been done before, considering d/Deafness in prison on both an audiological and cultural level. Moreover, excluding small-scale unpublished undergraduate dissertations, it was the first empirical study about d/Deaf prisoners in England and Wales to carry out face-to-face interviews with these prisoners. Finally, as the most in-depth research yet to be carried out about these particular prisoners in England and Wales, a greater level of insight was provided than previously available

A critical examination of the health promoting prison two decades on

Two decades since the WHO Regional Office for Europe outlined and published a report on health promotion in prison, which stimulated further debate on the concept of the ‘health promoting prison’, this paper discusses the extent to which the concept has translated into practice and the extent to which success has been achieved. This paper primarily focuses on why there has been a gap between the strategic philosophy of health promotion in prison and practical implementation, suggesting that factors such as ‘lifestyle drift’ and public and political opinion have played a part. A further argument is made in relation to the overall commitment of European countries and more broadly WHO in their support of settings-based health promotion in this context. It is proposed that there has been a weakening of commitment over time with a worrying ‘negative trajectory’ of support for health promoting prisons. The paper argues that despite these challenges, the opportunities and potential to address the needs of those who are often most vulnerable and excluded is colossal and acting to tackle this should be a greater priority

"A Prison within a Prison”?: Examining the enfolding spatialities of care and control in the Barlinnie Special Unit

This paper uses one of Scotland's most controversial experiments in penal reform – the Barlinnie Special Unit – to examine the enfolding nature of care and control in carceral space. Connecting with recent arguments relating to “caring architecture” and using the framework of historical carceral geographies, it showcases the spatial complexities of implementing caring practices alongside reforming tactics. Beginning with a discussion of the care and control nexus within institutional spaces and its historical legacy, it considers the use of small units within the Scottish Prison System. Using the Barlinnie Special Unit as a pivot, the paper opens up the complex spatial arrangements and spatial tactics of experimental prison reform. It first examines the spatial and architectural dimensions of the Special Unit. Second, the paper focuses on issues of routine and inhabitation and the emotional uncertainty this generated for prisoners. Overall, this paper seeks to argue the importance of examining experimental spatial practices in prison reform history to highlight the interwoven spatialities of care and control in every‐day institutional life

Palliative care in UK prisons: practical and emotional challenges for staff and fellow prisoners

Despite falling crime rates in England and Wales over the past 20 years, the number of prisoners has doubled. People over the age of 50 constitute the fastest growing section of the prison population, and increasing numbers of older prisoners are dying in custody. This article discusses some of the issues raised by these changing demographics and draws on preliminary findings from a study underway in North West England. It describes the context behind the rise in the numbers of older prisoners; explores the particular needs of this growing population; and discusses some of the practical and emotional challenges for prison officers, health care staff, and fellow prisoners who are involved in caring for dying prisoners in a custodial environment

Cognitive and Affective Empathy, Personal Belief in a Just World, and Bullying Among Offenders

Bullying extract a heavy toll on offenders and the prison staff alike. We examined factors that may contribute to having a positive attitude towards bullying in a sample of offenders. Specifically, we studied the previously overlooked relationship between age and positive attitude towards bullying and whether this relationship is mediated by affective and/or cognitive empathy. Furthermore, we assessed the relationship between personal belief in a just world and positive attitude towards bullying, given that previous research on the topic is scarce. We found that age predicted a positive attitude toward bullying, mediated by affective empathy. However, we did not find a positive relationship between a positive attitude toward bullying and a personal belief in a just world. The results are discussed in terms of their application in possible intervention programs

Challenges and opportunities for ex-offender support through community nursing

This study was a qualitative case study underpinned by “The Silences Framework” aimed at mapping the ex-offender health pathway towards identifying “touch points” in the community for the delivery of a nurse-led intervention. Participants meeting the study inclusion criteria were quantitatively ranked based on poor health. Participants scoring the lowest and endorsing their ranking through a confirmation of a health condition were selected as cases and interviewed over 6 months. Individuals in the professional networks of offenders contextualized emergent themes. The study indicated that pre-release, offenders were not prepared in prison for the continuity in access to healthcare in the community. On release, reintegration preparation did not routinely enquire whether offenders were still registered with a general practitioner or had the agency to register self in the community. Participants identified the site of post-release supervision as the “touch point” where a nurse-led intervention could be delivere

Exploring concepts of health with male prisoners in three category-C English prisons

Lay understandings of health and illness have a well established track record and a plethora of research now exists which has examined these issues. However, there is a dearth of research which has examined the perspectives of those who are imprisoned. This paper attempts to address this research gap. The paper is timely given that calls have been made to examine lay perspectives in different geographical locations and a need to re-examine health promotion approaches in prison settings. Qualitative data from thirty-six male sentenced prisoners from three prisons in England were collected. The data was analysed in accordance with Attride-Stirling's (2001) thematic network approach. Although the men's perceptions of health were broadly similar to the general population, some interesting findings emerged which were directly related to prison life and its associated structures. These included access to the outdoors and time out of their prison cell, as well as maintaining relationships with family members through visits. The paper proposes that prisoners' lay views should be given higher priority given that prison health has traditionally been associated with medical treatment and the bio-medical paradigm more generally. It also suggests that in order to fulfil the World Health Organization's (WHO) vision of viewing prisons as health promoting settings, lay views should be recognised to shape future health promotion policy and practice

Transfers from prison to hospital under Sections 47 and 48 of the Mental Health Act between 2011 and 2014

In England and Wales, prisoners with mental disorder of such severity as to warrant inpatient treatment may be transferred to hospital under the Mental Health Act. UK Government guidance recommends that this process should be completed within 14 days; however, evidence suggests that in many cases it can take much longer. This retrospective service evaluation of 64 male prisoners, who were transferred under Section 47 or Section 48, aimed to evaluate transfer durations. The mean time from referral to admission was 76 days. Prisoners with a psychotic disorder were admitted more quickly. Remand prisoners were admitted more quickly than sentenced prisoners. Findings suggest that, in the UK the transfer time of prisoners under Sections 47 and 48 of the Mental Health Act continues to far exceed the 14-day target which raises concern about equivalence of care for prisoners. Our findings support arguments for fundamental amendments to the admissions process

'Prove me the bam!': victimization and agency in the lives of young women who commit violent offences

This article reviews the evidence regarding young women’s involvement in violent crime and, drawing on recent research carried out in HMPYOI Cornton Vale in Scotland, provides an overview of the characteristics, needs and deeds of young women sentenced to imprisonment for violent offending. Through the use of direct quotations, the article suggests that young women’s anger and aggression is often related to their experiences of family violence and abuse, and the acquisition of a negative worldview in which other people are considered as being 'out to get you' or ready to 'put one over on you'. The young women survived in these circumstances, not by adopting discourses that cast them as exploited victims, but by drawing on (sub)cultural norms and values which promote pre-emptive violence and the defence of respect. The implications of these findings for those who work with such young women are also discussed