Correctional Setting

Because the Howard League for Penal Reform has been in the forefront of bringing international attention to the campaign in reducing self-injury and suicides in prison, I want to give a brief history of how this organization began. The Howard League for Penal Reform was established in the U. K. in1866 and named after one of the first prison reformers, John Howard. The Howard League for Penal Reform began as an inquiry into the “mysterious deaths” of five teenagers in Leeds prison in the U. K.

This was followed by research into why so many teens were committing suicide in young offenders institutions in the U. K. and has since grown to become an international organization which campaigns for the rights and humane treatment of those who are incarcerated. The Howard League for Penal Reform organization now has United Nations’ consultative status (Prison, 2006). Self-injury has been linked to a broad range of problems from developmental difficulties to physical and behavioral maladaptations.

Although there is more being written on it, the etiology of self-injury is still not clear. Most of the research on self-injurious behavior (SIB) comes from a mental health perspective (Leaf, et al. , 2006). Clinically, self-injury behavior has been linked to a variety of problems ranging from intellectual and developmental difficulties to emotional dysfunctions and physical and behavioral maladaptations. Some see it as a coping method in a debilitating environment (Thomas, et al. , 2006, p. 193). Typically, self-injury begins in early adolescence and continues for 10-15 years.

Self-injury both among prisoners and non-prisoners tends to be concealed from others so accurate statistics both inside and outside the correctional setting can be difficult to obtain. What is known is that neither control nor punishment are successful or healthy ways of dealing with inmates who are involved in self-injurious behaviors. It is more helpful to understand the broader context of the problem of self-injury. In addition, the role played in this by their environment which can facilitate as well as motivate the self-injurious behaviors are ignored when classifying it this way.

Suicide is the third leading cause of death in prisons and the leading cause of death in jails (Suicide, 2002). The suicide rate in detention facilities is nine times higher than within the community. Studies show us that the first 24 hours an inmate is incarcerated are the most vulnerable hours in regards to suicide within the correctional setting (Suicide, 2002). A large percentage of those who commit suicide in the corrections setting have been shown to have mental health problems or mental retardation problems.

In the report, “Suicides in prisons and jails: some frequently asked questions,” it is mentioned that 80% of those studied who committed suicide had been convicted of violent felonies, however, they only make up 56% of the prison population (Suicide, 2002). This study finds the primary cause of prison suicide is when the stressors cause psychological pain so unbearable that death to them seems the only means of relief. Suicidality is typically generated by a serious life crisis. The stress and pain increase as the crisis, or one’s perception of the crisis worsens.

Other factors included in creating this type of behavior include isolation from family, a controlled and dehumanized environment, legal problems, relationship problems and inmate conflict problems (Suicide, 2002). According to the book, Suicides in Prison, some of the life events which have been shown to increase the impulse of intentional self-injurious behavior while in the correctional setting include “threats, challenges, changes in hierarchal status, loss of social attachments, physical pain, loss of power or respect, among many others” (Snow, Towl & McHugh, 2002, p. 63).

In the book, Preventing Suicide and other Self-Harm in Prisons, it is noted that impulsiveness has to be a recognized factor in suicide due to the statistics that “two-thirds of suicide attempts are contemplated for less than an hour beforehand” (Dear, 2006, p. 6). In another study included in the book of suicide attempters between the ages of 13-34, twenty-four percent of those in this study reported it was 5 minutes or less planning. Service policies within the prison sometimes effect suicide in unintended ways.

One of the examples that is used in the book is that a Prison Service Policy in England and Wales was aimed at giving those in corrections their own individual cell. However, there is evidence that sharing occupancy of a cell actually reduces suicide. The book provides statistics in showing that during the times of the worst overcrowding of prisons during the years between 1994-1997, there was an actual decrease in suicides in those overcrowded institutions (Snow, 2002, p. 3).

Studies indicate there exists a lot of underreporting of suicides in prisons so the statistics that get reported aren’t as high as they actually are. Often, victims of suicide are rushed to the hospital and records will indicate the death as occurring at the hospital rather than within the corrections setting or not note the self-injurious act itself occurred in the correctional setting (Daniel, 2006, p. 165). Demographics factors indicate that more than half of the prison inmates who commit suicide are between the ages of 25-34.

The majority of those are single and have no job and have no family support (Daniel, 2006, p. 166). In focusing on the preventative side of self-injurious behaviors within correctional settings, I think its important to address some alternatives that are at least being looked in ways to change our correctional setting that contributes to unhealthy behaviors among those behind the bars. The book Instead of Prisons also addresses the self-injurious behavior within the correctional setting. The book brings out the point that prison is used to separate what we think are the just from the unjust.

However, the time spent in corrections often only reinforces while at the same time increasing the types of behavior that often bring the person into the correctional setting in the first place. The book examines how this “evil system of caging” creates and strengthens the behaviors society sends them in to correct when there really is no “corrections part” to our current correctional settings (Prison, 2005, p. 26). This book focuses on the reasons that prison can never be a place where individuals are reformed in a positive manner and how we need to focus on the abolition of prisons as they currently are.

According to the book, we need to recognize some of reasons the current correctional settings will never work the way they are which include: First…the very nature of prisons requires brutality and contempt for the people imprisoned. Second, recognizing that prisons are used mainly to punish poor and working class people, and forcing the courts to give equal justice to all citizens. Third, replacing prisons with a variety of alternative programs. We must protect the public from the few really dangerous people who now go to prison but more important, we must enable all convicted persons to escape the poverty which is the root cause of the crimes the average person fears most: crimes such as robbery, burglary, mugging, or rape (Prson, 2005, p. 57).

However, to present a fair and balanced research paper it must be noted that although many inmates researched stated they had not previously engaged in the self-injurious behavior prior to their time in corrections, others stated that they have. Common sense would indicate to us that many of the problems those within corrections had previous to being incarcerated will stay with them even while they are no longer a part of our mainstream society.

As reported in an article in The Journal of Traumatic Stress, it was noted that although the non-suicidal inmates reported a high prevalence of traumatic life events, those who actually engaged in suicidal behaviors had reported even higher prevalence rates of traumatic life events. Included among those traumatic life events were abandonment, sexual abuse, physical maltreatment, emotional maltreatment and suicidal attempts by significant others in their lives.

Some of the determining factors of those events and how strongly they impacted the lives of the inmates included the type of event, the timing of the event and the type of persons involved in the event (Blauuw, et al. , 2002, p. ). I feel it’s important to acknowledge pre-existing events and stressors for their role in self-injurious behavior in that if we feel the correctional settings have some responsibility in the self-injurious behavior, in some respects we must isolate those who did and did not engage in self-injurious behavior before entering corrections.

There have been many studies conducted in regards to women who engage in self-harming while in corrections in part due to statistics that indicate women engage in it significantly more often than men. Yet, statistics also show that men are more successful in their suicidal attempts while incarcerated than women (Daigle, 2006). Just like outside of corrections, the methods that women use, however, are usually less lethal methods.

Today there is more attention being paid to the gender needs and experiences of women behind bars. In reading the various literature available for this topic of self-injurious behavior, it is obvious that there are currently more studies conducted in this area than there ever have been in the past. This is possibly due to the fact there are more women incarcerated today and many of the policies of the past had been clearly written more specifically with the male prisoner in mind.

In the article, “Self-Harm in Women’s Prisons,” it shows how most prisons in the past would look at most female inmates who self-harm as a greater security risk and so prison personnel would increase security or penalize them for their self-injurious behavior. Today, more correctional settings are looking at self-injurious behavior in women and men more often than in the past as a coping method and putting more thought into how it is should be treated keeping the long-term results in mind rather than just the immediate need to force them to stop engaging in the behavior.

However, by their own admissions, correctional settings do not always know what to do even when they are aware that gender differences sometimes need to be considered within correctional settings. In the article, “Self-Harm in Women’s Prisons,” it was stated that organizations such as the National Institute of Corrections is conducting research on gender-specific programming. However, it was also mentioned that policy makers do not even know how to go about transferring the results of their completed studies to make those much needed improvements within the real-life correctional settings.

One can possibly make the proposal that more policy makers perhaps need to be female to possibly provide a greater insight, awareness and change to this problem with women and their high rate of self-injurious behavior while imprisoned. Although many who enter the correctional setting have been diagnosed with depression, oftentimes they are not being medicated or given the medical attention that those outside correctional settings receive. In the book Preventing suicide and other self-harm in prison, it is stated that “the great majority of those who commit suicide show a depleted or abnormal serontonin level” (Dear, 2006, p. ).

One has to wonder if this “depleted or abnormal serontonin level” also affected the inmate prior to their time in corrections and even affected their decision-making ability in getting them to the point of needing to be in corrections in the first place. This brings up another reason we have so many in corrections involved in self-injurious behaviors. After releasing those who were receiving treatment in mental facilities throughout the U. S. , it is obvious that those individuals would need to go somewhere.

President Nixon impounded federal funding for the mental hospitals in the U. S. , while after that President Reagan converted it to block grants while slashing funding of the mental health programs to pay for his tax cuts (U. S. , 2003). Because of this along with other factors, many of those in our prisons and jails are there due to having mental needs that are no longer cared for with the proper treatment and in the proper settings. These “mental patients” end up in our correctional settings where those in the field of corrections would be the first to admit they are not specialized in treating mental illnesses such as those that contribute to self-injurious behaviors.

As noted in the article, “U. S. Prisons and Mental Illness,” our prisons in the U. S. have become America’s default mental health system (U. S. , 2003). The book Psychological Research in Prisons emphasizes the need for structured awareness settings co-facilitated by both staff and prisoners as one idea to make problems more of a collaborative approach to dealing with issues such as the intentional self-injury among inmates. The book also suggests that “prisons should be giving consideration to the development of literature that has more than a superficial input from prisoners (Ireland, 2006, p. ).

This is becoming more realistic as there is more literature asking for input among those within the corrections setting. Therefore we are receiving more direct input to work with both in publications and in receiving direct input from inmates to group leaders and staff within some corrections settings. There are a variety of treatment methods and techniques now being recognized while some of them are being implemented to vulnerable inmates within corrections.

One such technique is Mindfulness-Based Cognitive Therapy (MBCT) which trains patients, or in this case, inmates to become more aware of their state of mind and it helps them to recognize when their mood is going down (Dear, 2006, p. 15). What it does is help to distance the inmate from the mental process taking place so they can therefore change the association or link between a negative mood and the negative thinking that would normally be set off.

This method along with becoming more observant and mindful of an inmate’s possible need for medication are becoming recognized as techniques that are included in some corrections training and passed on to more individuals within the correctional setting. CONCLUSION As seen in the various writings and research conducted with the problem of self-injurious behavior within our correctional settings, the problem is a result of a variety of factors.

Because prevention is seen as one of the best methods to treat any unhealthy behavior, more attention needs to be given to the diagnosis and treatment that creates the behavior prior to and during their time in the correctional settings. Although I feel we are just in the infancy of recognizing the magnitude of the problem, I feel there is hope in that it is now being considered a problem deserving of our recognition and of our resources. The first step is that we understand we are all a part of humanity and therefore any problem that affects one, affects many.

It is important we don’t see problems of those in our correctional settings as being less significant than those who are affected “on the outside” because in the end, we are all affected by each others’health and each others’ behaviors. “ A wish to be saved is an element in every suicide” Preventing Suicide and other Self-Harm in Prison Dear, 2006, p. 4 REFERENCES Blaauw, E. , Arensman, E. , Kraaij, V. , Winkel, F. W. , & Bout, R. (2002, February). Traumatic Life Events and Suicide Risk Among Jail Inmates: The Influence of Types of Events, Time Period and Significant Others. Journal of Traumatic Stress, 15 (1),

9-16. Daigle, M. S. , Cote, G. (2006 December 01). Non-fatal Suicide-related Behavior Among Inmates: Testing for Gender and Type Differences. Suicide & Life Journal. Daniel, A. , (2006). Preventing suicide in prison: A collaborative responsibility of administrative, custodial and clinical staff. Journal of the American Academy of Psychiatry and Law 34:2, 165-175 Dear, G. E. (2006). Preventing suicide and other self-harm in prison. Basingstoke England: Palgrave Macmillan. Prison Research Education Action Project. (2005). Instead of prisons. Oakland, CA: Critical Resistance. (2002).

Suicide in prisons and jails: some frequently asked questions. Retrieved June 5, 2007, from http://www. mces. org/Suicide_Prisons_Jails. html Thomas, J. , Leaf, M. , Kazmierczak, S. , & Stone, J. (2006 February). Self-Injury in Correctional Settings: Pathology of Prisoners or of Prisons? Criminology & Public Policy 5 (1), 193-202. Towl, G. J. , Snow, L. , & McHugh, M. (2002). Suicide in prisons. Oxford: BPS Blackwell. (2003, October 22). U. S. prisons and mental illness. Retrieved June 25, 2007, from Metafilter community weblog Web site: http://www. metafilter. com/29102/US- Prisons-and-Mental-Illness