Prisoner perceptions of the environmental impact on self-harm and suicidal behaviour
| Date | 02 December 2024 |
| Pages | 115-130 |
| DOI | https://doi.org/10.1108/JFP-12-2023-0068 |
| Published date | 02 December 2024 |
| Subject Matter | Health & social care,Criminology & forensic psychology,Forensic practice,Sociology,Sociology of crime & law,Law enforcement/correctional,Public policy & environmental management,Policing,Criminal justice |
| Author | Lauren Nixon,Gemma Goldie-Chaplin |
Prisoner perceptions of the environmental
impact on self-harm and suicidal behaviour
Lauren Nixon and Gemma Goldie-Chaplin
Abstract
Purpose –Improving prison safety by reducing self-harm and suicidal behaviour remains a
government priority (Ministry of Justice, 2021). This involves developing a better understanding
of the relationship between prison environments, self-harm/suicidal behaviour and the prison
conditions supporting a reduction in such behaviour. Through interpretive phenomenological
analysis, the authors aim to explore prisoners’ perceptions of one prison environment, considering
if/how the environment has impacted prisoners need for support via the assessment, care i n
custody and teamwork (ACCT) process.
Design/methodology/approach –Data was collected through semi-structured interviews with seven
prisoners at an adult male establishment who had not been on an ACCT since arriving therebut had at
least twoactive ACCT documents in the 12 monthsprior to transfer.
Findings –Analysis identifiedfour superordinate themes: facilities,population, mentality and interaction
with staff. This research increases understanding of specific factors contributing to prisoner’s lack of
need for supportvia an ACCT document.
Research limitations/implications –A small sample within one prison for those convicted of sexual
offences was used. Therefore, the findings are notfully generalisable to all establishments. Theauthors
did not control for factorsbeyond the environment that could have contributedto prisoner’s lack of need
for supportvia an ACCT document.
Practical implications –By conducting research, Forensic Psychologists are uniquely placed to
increase researchevidence to support the improvement of prison safety,whilst promoting its application
in practice.Several recommendations aboutenhancing prison environments are made.
Originality/value –The findings provide insight into specific aspects of a prison environment that
impactsprisoners’ level of self-harm and suicidal behaviour.
Keywords Self-harm, Suicide, Wellbeing, Prison environments, Forensic psychologists
Paper type Research paper
His Majesty’s Prison and Probation Service (HMPPS)policy highlights the importance
of creating and maintaining safe and supportive environments. This includes
preventing incidences of self-harm and suicide. Assessment, care in custody and
teamwork (ACCT) is a case management approach used in prisons since 2005 to support
those at risk of self-harm or suicide (Pikeand George, 2019).
Despite the introduction of the ACCT process, the prevalence of self-harm in custody
has been estimated to be 5–6% (Hawton et al., 2014), exceeding the less than 1% of
adults in the general population who self-harm yearly (Borges et al.,2010). Research
has found that individuals in custody who self-harm are at a six to eight times increased
risk of suicide in custody and half of individuals who die by suicide in custody have a
recorded history of self-harm (Humber et al.,2013;Fazel et al.,2008). Within a recent
safety in custody report (Ministry of Justice, 2022), there were 52,972 self-harm
incidents in the 12 months to June 2022 in UK prisons, a 0.4% increase from the
previous year. In the 12months to September 2022, there were 70 self-inflicted deaths,
Lauren Nixon and Gemma
Goldie-Chaplin are both
based at HMPPS
Psychology Services,
Berkhamsted, UK.
Received 1 December 2023
Revised 5 July 2024
Accepted 12 August 2024
The authors would like to thank
their co-author, Gemma Goldie-
Chaplin for her supervision and
unwavering support throughout
the years in attaining
membership as a Registered
Psychologist. Authors will be
forever grateful. Authors would
also like to Jolene Taylor,
previous line manager and
supervisor for her support,
guidance and encouragement
throughout the years, authors
truly grateful.
DOI 10.1108/JFP-12-2023-0068 VOL. 27 NO. 1 2025, pp. 115-130, ©Emerald Publishing Limited, ISSN 2050-8794 jTHE JOURNAL OF FORENSIC PRACTICE jPAGE 115
a 16% decrease from the previous year, highlighting the significant need to support
those engaging in these behaviours.
Research into suicide and self-harm in prisons has found there were several major
precipitating or motivational dimensions to self-harm and attempted suicide (Snow, 2002).
These included offence related, interpersonal, symptom relief, instrumental and situational.
This research suggested the prison environment can be a trigger for self-harming and
suicidal behaviour. Situational factors such as boredom, feeling scared and maladaptive
coping in response to imprisonment werealso identified as a motive. This is supported by a
recent meta-analysis which found prison-specific environmental risk factors for self-harm
(Favril et al.,2020). They identified further specific factors that were also relevant including;
solitary confinement, disciplinary infractions and experiencing sexual or physical
victimisation while in prison, suggesting that others’ actions within the environment as well
as physical environmental stimuli can be relevant. In addition, prisons with a higher
proportion of the area within their perimeter given over to natural vegetation exhibit lower
levels of self-harm (Favril et al.,2020), suggesting the physical environment and visual
presentation can have an impact on subsequent self-harm.
Liebling (2007) suggests that some prison environments are more “survivable” than others,
as prison culture can significantly impact prisoner wellbeing. The frequency and quality of
interactions between staff and prisoners has been shown to impact prison culture and how
it is experienced by individuals, particularly regarding levels of trust and anxiety (Liebling
and Arnold, 2012;Molleman and van Ginneken, 2015). This outlines that factors that may
impact self-harming behaviours need to go beyond the physical environment and should
consider the culture and relationships within these. A recent meta-analysis completed by
Zhong et al. (2021) concluded clinical, institutional and criminological factors were
associated with suicide in custody. For example, current psychiatric diagnosis, occupation
of a single cell and remand status. Similarly, in a meta-analysis completed by Favril et al.
(2020), the strongest associations with self-harm in prison were found to be current or
recent suicidal ideation, lifetime history of suicidal ideation and previous self-harm. Any
existing psychiatric diagnosis was also strongly associated with self-harm.
Although not conclusive, itis acknowledged within this research that prisoners may import a
vulnerability for self-harm into prison (characterised by social disadvantage, trauma,
violence and poor health) that might interact with custody-specific stressors (e.g. isolation,
victimisation and long sentences) and thereby increase the likelihood of self-harming in
prison (Favril et al.,2020). Therefore, exploring further how/if a specific custodial
environment has contributed to lower rates of self-harm and suicide will add to literature.
Psychologists are one of the many experts amongst front-line staff that “bring together
innovative thinking and best practice to address the drivers of violence and self-harm in
prisons” (Ministry of Justice, 2022). Psychologists working within prisons use an approach
in line with the scientist practitioner model (Bierie and Mann, 2017) with emphasis on using
research (science) to inform their practice.A Senior Psychologist within HMPPS recognised
that exploring factors that may have contributed to an adult male establishment housing
men convicted of sexual offences (MCOSO’s) having significantly lower rates of prisoners
requiring the support of an ACCT document when compared to a comparator site could
add to the literature and evidence-based practice. Specifically, to ways in which
establishments and staff can further support the reduction of self-harm and suicidal
behaviours. Therefore, this research intends to explore what/if anything about the
environment at this specific adult male establishment housing MCOSO’s has contributed to
individual’s lack of self-harm and suicidalbehaviours following their transfer there. Research
shows that within prisons it is critical that research findings are disseminated and
communicated effectively and that failing to do so makes it difficult for learning to take hold
(Bierie and Mann, 2017;Bonta and Andrews, 2016). Furthermore, it is recommended that
scientist–practitioners engage directly with leaders and staff, explaining what works and
PAGE 116 jTHE JOURNAL OF FORENSIC PRACTICE jVOL. 27 NO. 1 2025
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