The issue of self-harm and prison life is not well understood. Despite this, there has been recent publicity about this issue. For example, Richard Gardside from the Director of the Centre for Crime and Justice explained in response to the Prime Minister's recent announcement that 'violence, self-harm, suicide and squalid living conditions are nothing new in our prisons'. A study which interviewed prison staff found that many people working in prisons claim that mental illness is a facet of prison life and working in prisons (Jordan, 2011). This is not acceptable and while many politicians and campaign groups are campaigning for better conditions in prison, there is very little advice given about how to deal with people who self-harm. Unlike other recent publicity, this article will explain little known facts about self-harm in prison.
What is self-harm?
MIND defines self-harm as:
Cutting or inserting objects into your body
Over-eating or under-eating
Hitting yourself or the walls
Overdosing
Exercising or scratching excessively
Self-harm appears to be a self-explanatory term; however there are many ways people can harm themselves other than in this list by MIND. While many people assume self-harm means hurting yourself there are many other ways which are less obvious. For example, MIND explains that eating disorders, exercising excessively or scratching or hair pulling are signs of self-harm. The problem with women in prison is that issues such as eating or exercising can also have other implications. In particular, an interesting issue for women in prison is that food can be a way they can resist the power of the prison. For example, research has explained that female prisoners can use food as a way they can have control over their lives (Smith, 2002).
Why do people harm themselves?
A recent study has been released by the Howard League which is about the cost of suicide. This report explains that the impact of suicide in prison can be costly in a personal sense for the families involved as well as adding an extra financial burden on prisons, health services and staffing costs (Howard League, 2016). Other recent studies have shown how women are more likely to suffer with mental health problems in prison than men (Wright, et al, 2016). Despite this known link between self-harm and prison, there is very little knowledge about why people self-harm. According to MIND, which is a charity that supports people in the community and prisons, there is no easy explanation for self-harming.
What can be done for women in prison?
The issue of suicide in prison creates headlines and reports. Following a number of suicides of women in prison Baroness Jean Corston undertook a review in 2007 with women in the criminal justice system. This review (Corston, 2007) used the term 'vulnerable women'. In particular Corston (2007) claimed that small numbers of vulnerable women have impacts on care and services which is 'disproportionately large with significant resources spent on health, development, education and social services'. Recent suicides of transgender people in prison have also led to a review by the prison estate in England. Despite this, self-harm is an issue which is not dealt with in a co-ordinated way. Part of the reason for this is that mental health issues are defined in competing ways through labels. For example when women are pregnant, mental health is defined as a perinatal mental illness which is a wide definition that can have serious consequences such as maternal suicide (Edge, 2011). While there has been recent concern about the mental health of women in prison, this has not led to answers that can provide immediate answers about what can realistically be done for women in prison.
While the prison services recognise extreme acts of self-harm and attempted suicide, there have been concerns for many years about how the prison service should respond and support women in prison. While many campaigns by reformers and research by academics investigate the extreme situation, there remains very little knowledge. MIND explains that many people keep self-harm private and it is painful to have some behaviour understood as self-harm. While it is possible that incidents of self-harm have got worse, with prisons who are stretched to capacity, it is important to take into account that women who are in prison are over-represented by people who are discriminated against and have complex intersecting health, social and welfare issues. A review claimed that female prisoners who report abuse in their lifetime is double male prisoners and self-harm was ten times higher than men (Robinson, 2013). While the recent report by the Howard League have tried to put a cost on suicide in prison, future understandings should also recognize other related issues such as the incidents of self-harm and the possibility of many women in prison who are suffering in silence.
Self-harm in women's prisons: is collaborative care and self management the future?
This is the title of a conference that is due to be held on the 1st and 2nd March in Manchester, England. This conference will take place over two days and includes representatives from prisons, researchers and organisations. The intention of this conference will be to consider the implications of self-harm for women and will take into account perspectives from medical practitioners, therapists, prison workers as well as the experiences of women. For more details go to: http://psychiatricethics.com/2016/01/14/self-harm-in-womens-prisons-conference/