A critical exploration of the management of self-harm in a male custodial setting: Qualitative findings of a comparative analysis of prison staff views on self-harm

There are a growing number of prisoners who self-harm in prisons in England and Wales despite adopting a safer custody ethos. An in-depth study of staff views of self-harm from various agencies within the prison and the integration of their different forms of expertise and perspectives to address this problem is lacking. Negative attitudes to self-harm have been identified as an additional risk factor to this problematic behavior. Aim: This study identified and compared relevant attitudinal dimensions of custodial and healthcare staff on prisoners who self-harm in an Adult Male "Local" Category B prisons (referred to as the study prison) where self-harm was twice the national average (14%). Method: Semistructured interviews were conducted with 37 prison staff (14 nurses and 23 prison officers) as part of a mixed methods research study where documentary evidence and a self-harm questionnaire were also used. This paper discusses and presents the findings for the thematic analysis of the semistructured interviews. Findings: The key themes identified were understanding self-harm, building relationships, organizational issues, occupational issues, and care management of self-harm. The findings suggest that most prison staff felt unsupported and inadequately equipped to manage self-harm, and reported interdisciplinary conflict on its collective management.