A systematic review and mixed-methods synthesis of the experiences, perceptions and attitudes of prison staff regarding adult prisoners who self-harm

BJPsych Open

article

Thomas Hewson¹  Kerry Gutridge³  Zara Bernard⁴  Kathryn Kay⁴  Louise Robinson⁵ 

[1] Faculty of Biology, Medicine and Health, University of Manchester;and North West School of Psychiatry, Health Education England, University of Manchester;Centre for Women's Mental Health, University of Manchester;Greater Manchester Mental Health NHS Foundation Trust;Division of Psychology and Mental Health, University of Manchester;and Lancashire and South Cumbria NHS Foundation Trust

关键词: Self-harm;    suicide;    prison;    staff;    attitudes;   

DOI  :  10.1192/bjo.2022.70

学科分类：计算机科学（综合）

来源: Canadian Society For Pharmaceutical Sciences (Csps).

【 摘 要 】

Background Self-harm, including suicide, is common among prisoners. Staffattitudes and perceptions regarding self-harm may affect qualityof care and patient safety.AimsTo systematically review the experiences, perceptions and attitudes of staff in adult prisons regarding self-harm.MethodSystematic searches of EMBASE, Medline, PsycINFO and CINAHLdatabases were conducted, and supplemented by handsearching and grey literature review, to identify relevant Englishlanguage articles published since the year 2000. Articles werescreened by two authors and evaluated with standardisedquality appraisal tools. Qualitative data were analysed thematically, whereas quantitative data were narratively synthesisedbecause of high study heterogeneity.ResultsTwo thousand articles were identified, of which 32 wereincluded, involving 6389 participants from five countries. Moststudies were moderate (n = 15) or poor (n = 10) quality, and sevenwere rated as good quality. Staff frequently witnessed self-harmand described multiple perceived risk factors and causes of this.Perceptions that self-harm is ‘manipulative’ or ‘attention-seeking’ were associated with hostility toward prisoners and lowerquality of care. Perceived barriers to preventing and managingself-harm included low staffing levels, prison environments andculture, poor staff confidence and insufficient training. Theimportance of multidisciplinary teamwork and building staff–prisoner relationships were highlighted. Staff occasionallyexperienced intense psychological reactions to self-harm, whichresulted in adaptive or maladaptive coping that influenced theircapacity to care.ConclusionsThere are mixed attitudes and perceptions toward self-harmamong prison staff. Further training, support and resources arerequired to protect staff’s well-being and improve self-harmprevention and management in prisons.

【 授权许可】

CC BY|CC BY-NC-SA|CC BY-NC-ND