Review: A systematic review and mixed- methods synthesis of the experiences, perceptions and attitudes of prison staff regarding adult prisoners who self-harm
The systematic review featured here was tweeted:
https://twitter.com/t_hewson/status/1533800510343499779
- and being mixed-methods caught my eye.
Below, I have mapped some of the concepts, themes and findings of the review to Hodges' model, adding some italicised points of my own.
The relevance of Hodges' model, in carceral, forensic, health and justice contexts is marked. The vertical axis's distinction of individual and group and the need to protect the public from dangerous individuals stands out. As does an individual's physical and mental state to the State - in the political domain. This extends to the Sociological as to the public's expectations over 'law and order' and what - should, must - happen to wrong-doers.
Where the model can help reflection, scoping, critical thinking and problem solving is in the disciplinary bridges it provides between knowledge, or what can be 'silos'; and, the many interfaces that are found within our activities, health, educational or generally. There are several interfaces in this systematic review: Prison staff - prisoner; prisoner - prisoner; prisoner - family; and where the custody function, butts up against that of the health - and how physical and mental health needs are met - or in this environment (literally) negotiated. There is a related finding (page 6):
"In contrast, in one establishment with low rates of self-harm, staff felt that their roles of ‘carer’ and ‘security officer’ were well integrated."
| SELF: Prisoner / Prison Officer (and Other roles) Prison staff - perceptions & attitudes self harm (thoughts, motivation) suicide (thoughts, motivation) Staff confidence, skills: Awareness - Prevention Caring - empathy 'manipulative', 'attention seeking' Insufficient training expressed emotion Staff member's wellbeing Capacity to care 'deep acting' emotional intelligence 'hope' QUALITATIVE | SELF: Adult Prisoner, Prison Staff [repetitive] self harm (means, action) suicide (means, action) Carceral environment (PRISON) self-harm - factors Research: Methodology, [Mixed] methods Systematic Review self-report - non-validated questionairres TIME [shift]: 'all the time', 'every time' location, time Staff member's wellbeing Capacity to care 'surface acting' Effect of COVID on self-harm: men/women Assessment tools ACCT - Assessment, Care in Custody and Teamwork processes QUANTITATIVE |
| Prison - Staff Culture male::female staff -> prisoner -> relatedness Staff - Prisoner interactions in self-harm management Behavioural - learning/copying role - models clarity 'shared/pervasive sense of hope' 'Life skills - literacies' Social determinants of Health (Crime?) |
Self-harm: Policy NICE guidelines 'Correction', Young Offender Inst. control–support model demands - resources model Occupational stress Staff Support Training Prison officer training 'Intro 101'? |
The comments gleaned from staff are very informative. Also of interest here are ongoing developments in trauma-informed care and this can cover emotional trauma, as in abuse, plus head injury which is a key screening initiative. Achieving parity of esteem across physical and mental health, demands a more delicate balance in health and justice.
'Hope' is a concept subject to much analysis, for example, in the healthcare, sociological and philosophical literature. Incarceration, must bring its own 'trauma', which will vary in its signature across individual, age, first-offence, recidivism, offence, legal processes ... and its impact upon hope. From the challenge of the individual prisoner and their hope, there is the challenge for prison management and policy to instill, facilitate a shared, sense of hope. Amid the news on the state of prisons, there are no doubt examples where this can and is delivered.
orcid.org/0000-0002-0192-8965