At arms length: the development of a self‐injury training package for prison staff through service user involvement

Publication Date09 Dec 2011
AuthorJames Ward,Di Bailey
SubjectHealth & social care
At arms length: the development of a
self-injury training package for prison staff
through service user involvement
James Ward and Di Bailey
Purpose – People who self-injure present a serious concern for many healthcare providers and nomore
so than for those working in the female prison estate. Despite the prevalence of self-injury and recent
policy highlighting the need for staff training, misunderstanding and misinterpretation of self-injury is rife
within the healthcare professions often demonstrated by poor levels of service and care. This paper
seeks to describe the development of a self-injury training package for prison staff, throughservice user
involvement, in order to address such deficits in care.
Design/methodology/approach – A participatory mixed methodological design engaged both staff
and women in prison. Women offenders were involved in the development of training drawing upon their
unique experiential expertise.
Findings – In total, 43 per cent of staff working directly with women recognised the need to develop
their understanding of, and skills to manage, self-injury.Key messages women wanted to convey to staff
included how to communicate effectively and demonstrate empathy.
Research limitations/implications Service user involvement in the training of staff is achievable in a
prison environment. Women and prison staff identify the need for on-going training in relation to the
management of self-injury.Limitations of the sampling strategies are acknowledged but not considered
Practical implications The authors assert that service user involvement is crucial in the development
of meaningful training in the management of self-injury.
Social implications The involvement of service users in prison staff training empowers those involved
and may foster improved prisoner-staff relationships.
Originality/value – Service user involvement in prison staff training has no precedent in the UK.
Keywords Self-injury, Service user involvement, Prisons, Women, Mental health
Paper type Research paper
Self-injury in the women’s prison system has increased dramatically over the last decade.
In 2001, the Howard League reported that there were 889 recorded incidents of self-injury
across the female prison estate whereas in 2009 the women’sprison in which this research is
based recorded 834 incidents alone. The needs of individuals who use self-injury are often
complex and multifaceted including mental health and personality difficulties (Lord, 2008;
Crowe and Bunclark, 2000), experience of trauma (Simpson, 2004), affect regulation
(Klonsky, 2007) and communication styles (Pembroke, 1994). The prevalence and
complexity of self-injury makes it imperative that prison staff, who are rarely mental health
professionals, are well trained to enable them to respond effectively.
The primary aim of the current three-year study is to improve outcomes for women who
self-injure in prison. Self-injury is defined as a non-fatal act, regardless of the act’s nature,
that was completed in the knowledge that the act would be harmful (Hawton and
van Heeringen, 2000; Morgan, 1979). The study employs a participatory action research
DOI 10.1108/17556221111194518 VOL.6 NO. 4 2011, pp. 175-185, QEmerald Group Publishing L imited, ISSN 1755-6228
PAGE 175
James Ward is a Research
Associate at the School of
Applied Social Sciences,
Durham University,
Durham, UK. Di Bailey is
Head of Division for Social
Work, Social Care and
Health and Counselling at
the School of Social
Sciences, Nottingham Trent
University, Nottingham, UK.
This research is a Knowledge
Transfer Partnership between
the North East Offender Health
Commissioning Unit
(NEOHCU) and Durham
University with the collaboration
of the Ministry of Justice and
Department of Health. It has
been funded by the NEOHCU
and the Economic and Social
Research Council. The authors
would also like to acknowledge
the work and assistance of the
participants whose continuing
enthusiasm to contribute to
change is very much

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