Self Harm Problem in Prisons - Essay Example

Self harm problem in prisons. What initiatives have been implemented by the Prison Service to reduce the likelihood of self harm? Self harm in prisonis a rising problem because people who spend their term in jail cannot get in terms with their life and have a thought that they cannot overcome the situation. This desperation leads people to harm themselves and may even lead to suicide. Prison Service provides assistance to prisoners to deal with the situation and overcome their psychological struggle. Several methods are adopted by prison services to improve the well being of prisoners especially when there is a chance for self harm. Prison staffs are given guidance to help prisoners who are vulnerable to self harm or suitable. The staff also provides advice and assistance on the support available to prisoners. The staff also provides the company of a safe person as a cell mate or a person who can listen to the woes of the disturbed person or a staff member extents assistance to find a solution. In extreme cases, the prison staff observes the prisons and engages in conversation during specific intervals of time and the reason for being in prison is explained to the prisoner. Prison Service employs a well planned system known as ACCT to recognize and assist prisoners who are like to commit suicide or self harm. ACCT (Assessment, Care in Custody and Teamwork) is practices in all prisons from April 2007. This method is in replacement to the old F2052SH system with flexibility and the support of multi disciplinary action to evade prisoners from self harm. The method gives confidence to staff to extent their assistance and personalized care to distressed inmates, to assist neutralize a probable suicide attempt and to assist prisoners with long term requirement (when the person has repetitive history of self harm) to decrease their distress. The ACCT method makes sure that all prisoners participate in the process. Prisoners are required to undergo an interview with an expert Assessor who will then chart out personalized care plan. Prisoners are also encouraged to participate in timely Cases Reviews for the support and care provided to them. In addition to Prison Services there are several assistance mechanisms and agencies that work for prisoners in crisis. Peer assistance schemes are operated in most of the prisons. The Listeners schemes is one such systems where inmates are given training by Samaritans and learn to hear to the problems of other prisoners by maintaining confidentiality in case emotional assistance is required for some reason. Other assistance available to prisoners in the prison premises are assistance for substance misuse, counseling, input of Chaplaincy, access to Samaritans, mental health providers and general health care providers. Past experiences reveal that involvement of prisoners in systems like ACCT, prisoners who are despair revive and benefit from these schemes by making some developments in education and sport. Certain prisons operate confidential at risk hotlines and a person can simply send a message to the answer machine. The message may be related to a person’s acquaintance or friend who is despair, shows withdrawal symptom and has no interests in normal course of life or regular daily activities. A message can also be send to the prison if a person is alone and desolate, struggling to face reality at prisons or if a prisons is hopeless and feels angry. When the friends and families of a prisoner provide support, a significant change is brought to the desperate situation of an inmate and instills a ray of hope on life (Self Harm). The ACCT approach The ACCT approach was formed to reduce distress and to create a setting where distress inmates could request assistance. The approach also aims to provide a caring and secure atmosphere and recognize persons with assistance requirements while undergoing the crisis and after the recovery. The approach has designed plans to listen to individuals at risk of self harm and planning methods to decrease their troubles and assisting them to ascertain a method of engagement and to choose a better way of living. Though these method entails close monitoring it is effective only in the short run. The approach is designed to observe, ask and listen to distressed people since some individual conceal their actual intention even if their mood disclose that they are worried. ACCT requires observing the behavior of people to determine the possibility of self harm in an individual which range from crying to fighting, withdrawal from socializing to drug misuse. The ACCT approach also envisages process to analyze the thoughts and feelings of inmates which lead to self harm. The initial response of any support method is to ask the person about the concern. If risk is recognized, the ACCT plan is opened and assigned to the prisoner’s team manager or concerned officer for further action. The team manager then consults with concerned staff to maintain the prisoner safely before any comprehensive plan in drawn out. The Unit Manger then informs the Assessor Team to conduct an interview with the inmate at risk at the earliest. The Case Review includes the report of the interview and the Case Review Team will ascertain the amount of risk and design a CAREMAP (care and management plan). A record is then maintained to register the discussions and observations with the inmate and highlight the circumstances that are likely to stimulate the level of self harm or possibility of suicide. Prison Service requires the supervision in jails to be active. Night Orderly Officers and Team Managers are entitle greater responsibility to monitor the behavior and negative actions of inmates. Moreover, Prison Service has made it mandatory for the jail staff to record all self harm attempts of prisoners as required in the ACCT plan with the basic objective of caring for inmates who are at risk of self harm. Further, the CAREMAP under the ACCT Approach requires that the care management plan should have the consent of the prisoner. CAREMAPs are drafted for individual case and address the issues of a single person whether it is distress or the feeling to commit suicide or self harm because some people need lot of attention and counseling to detach from their negative emotions while some require lesser support though for a longer duration. The ACCT method requires prisoners to carry their records if they are transferred to another prison. Methods like cell sharing does not apply in the case of juveniles because young people are vulnerable to the stress of their cell mate. Further, the Listener scheme is not recommended in the case of juveniles in prison because they do not have the experience to handle tough situations like self harm. A juvenile who commit or vulnerable to commit self harm is protected by the Child Protection Coordinator through the Youth Offending Team, advocacy services or social services (The ACCT approach (n.d)). Carousel is an initiative to decrease self harm, improve coping techniques and self respect. It is an eight week team treatment assistance programme for females who repeatedly commit self harm. Team treatment is combined with personalized discussions, relaxation, art therapy, physical exercise and educational activities (Resettlement Services 2004). The introduction of HM Prison Service resulted in the decrease in the number of self harm and suicide in prisons. HM Prison Service was put into practice in June 2000 due to the unprecedented increase in the number of suicides. HM Prison Service gives importance to prevent suicide and provide assistance to inmate under a holistic approach. The internal assessment of suicide and self harm was implemented in June 2000. The new method is fully endorsed by Prison Service Management Board and the ministers and it is supported by required resources for implementation and proper operation in the prison. The review assessed the effect of the existing policies of Prison Service to find out and manage the cases of suicide and self harm. The review made recommendation to effect changes in the three year policy drafted to record a year to year decrease in self harm and suicide. The review also surveyed the number of staff working for the Prison Service Suicide Awareness and Support Unit to effect necessary increased or change to the existing staffing policies (Leech, M. & Cheney, D.2002 p.594). Advanced care for inmate who repeatedly harm themselves without an attempt of suicide There are many reasons that drive prisoners to cause self harm and the intention is not always to commit suicide. Majority of individuals harm themselves to manage their negative thoughts to get rid of terrible and traumatic thoughts or to take out their anger. Self harm is mostly a coping method in the place of normal methods like using drugs or alcohol or the assistance from family and acquaintances since these are not available in prison. Therefore staff in prison should draft a customised plan according to the relevance of the situation. The concerned personnel officer is required to engage in conversation regularly with prisoners to ascertain any motive for self harm. Prison Services has to adopt a non-judgemental approach to identify probable self harm and find alternative and reduce the incidence. The non-judgemental approach should be an initiative that serves in the long run and create a feeling in inmates that there is nothing like self harm. It is also recommended that this approach should not reward a prison for not committing self harm or punish a person for committing one. Prisons may offer self harming inmates with dummy materials so that there is no actual impact with self harm but the person is relieved that he has committed one using red pens, elastic bands or ice cubes. This is to relax the individual and the person may be given other distraction practices like drawing books (Planning and providing care for prisoners at risk of suicide and/or self harm 2007). Self harm control and prevention of self harm for female inmates Self harm rules are drafted for all inmates including young, old, female, male and people from all ethnicities. However, considering certain requirements and vulnerability of female inmates, there are additional prevention methods that are gender specific. The gender specific approach is not a preferred treatment; rather the approach gives importance to treating women from a different perspective with a better degree of care. The staff working in women’s prison have the knowledge that female prisoners are put into custody when they already have several troubles to cope with. Troubles comprise mental health issues, drug misuse, family problems and past abuse which increase their vulnerability to self harm and suicide. Off late the number of self inflicted deaths has been on the higher side among women prisoners when compared to male prisoners. The incidence of self harm is twenty times more in women when compared to those in men. Special care is extended to women during their initial days in prison because majority of women commit suicide within their first week in prison. Therefore specific guidance is provided to prison staff and policies are drafted to provide required monitoring and support to new woman entrants in prison. Foreign national inmates comprise a high proportion in prisons. Therefore women’s prison have specific guideline to handle foreign women prisoners to assist them overcome the language barrier. These group are also at risk of self harm because it is usually their first time in custody, feel shame for self and family, culture and their community and for certain woman they feel away from their family and feel despair. They are usually reluctant to request support and so voluntary assistance from the Prison Service is initiated. The policy with regard to these prisoners entails identifying the language of the prisoner, provision of adequate supply, language assistance and the opportunity to inform their family about the prisoner’s whereabouts. While providing these facilities, prison staff should make sure that these efforts do not cause additional stress to the woman prisoner (Suicide prevention and self-harm management for women prisoners 2007). Steps from the authorities after self harm of an inmate Managers are required to take immediate action and not to tolerate self harm of any kind, even if it is presumed to be manipulative. This is because self harm is associated with an objective and the prisoner is provided adequate support to find a systematic solution for their requirement. Serious incidents are investigated to find the circumstances that led to self harm and thereafter to provide better health care in an outside hospital. Inclusion of family interference is crucial in such cases. Death in custody is a disturbing event for other prisoners and prison staff. Therefore Safer Custody Team and Care Team work to support them. Watching the suicide attempt of self harm can cause a traumatic after effect to prisoners. There prisoners, specifically those close to the person who commits self harm are treated to overcome the situation (Actions following an incident of self-harm 2007). Initiatives from Prison Service to avoid self harm among young inmates Specific strategies are drafted to deal with self harm issues of children considering their specific requirements. These strategies are common for young girls and boys though certain woman related issues are dealt according to guidelines in the Gender Specific Approach. It is found that adults who commit self have previous experience being in prison, disturbed family, abusive events in life and self harm as young prisoners. Therefore intervention among young prisoners is to care for them and support them as a matter of early intervention to avoid repetition of self harm as adults. Prevention of suicide and management of self harm is a part of the prison’s safeguard policies and demands strategic and implementation combination with the decrease in violence and protection of children. Other initiative of Prison Service includes multi-disciplinary risk evaluation, management of mental health, and control of substance and drug misuse (Suicide prevention and self-harm management for young people 2007). Early prevention policies of HM prison service placed high risk individuals in isolated cells called strip cells where furnishings are limited. But isolation can negatively impact the prisoner which includes depression, frustration and isolation in the unusual setting. Due to unintended risk this method of prevention was abolished in 2000. The Safer Custody Group in HM Prison recommended the use of safer cells by removing ligature points that served as the mode for committing suicide by hanging and constituted around 93 percent of the suicide methods in prison. Safer cells have humane setting when compared to the strip cells. Safer cells were introduced in 1997 and the discovery of a new method of committing suicide was conceived to be a slow process. Further safer cells do not have a negative impact on the inmate. Safer cells are designed with hard materials so that prisoners do not break them to be used for self harm by cutting or poking (Summers, L. (n.d)). The initiative of Scottish Prison Service to reduce self harm and suicide has created an environment of support and care for prisoners. This was achieved through a massive training programme with the implementation of support and yearly refresher programme. Further, the Scottish Prison Service instilled methods to identify, evaluate and manage risk. Multidisciplinary group work is one of their key steps towards care and support for self harm victims and those vulnerable to self harm. The method emphasises on maintaining a healthy mental state of prisoners and prison officer’s extent details to health officials. Regular review and communication is effected through case conferences where all involved in the prison and health support share information. ACT strategy is updated so that prisoners do not get familiar with self harm support policies. However, the concern remains when a prisoner leaves jail and goes back to the community. The SPS could witness positive evidence in terms of reduction in the number of self harm with the implementation of mental health support and Listener scheme. Prisoners tend to be more responsible about self care and case conferences and participate with regional communities, faith groups and organisations. These were achieved when the SPS did not impose punishment for self harm and implemented prisoner friendly policies. At the Cornton Vale prison, the authorities evaluate ten highly vulnerable woman prisoners and thirty less vulnerable inmates based on the ACT policy and the Doctor, Nurse and Prison Officer gives inputs on the assessment. This method becomes ineffective if the prisoner is already aware of the system. The Cornton Vale prison also proposes to implement Enabling day care model to deal with inmates who have self harm problems. Care is not considered as a separate unit in the prison but it is a daily therapeutic activity to maintain contact with inmates in an effective manner with a constructive approach among high risk individuals. The mental health providers employ open referral strategy at Cornton Vale prison. One third of woman prisoners report anxiety issues and a negligible part of them have permanent and severe mental problems. Another set of woman prisoners have drug associated issues and personality disorder (Reducing Suicide and Deliberate Self Harm 2005). The initiatives of Prison Service to reduce the likelihood of self harm include the appointment of large number of forensic psychologists. HM Prison Service employs around six hundred psychological staff and hundred psychology graduated are appointed as trainee forensic psychologists and assistant forensic psychologists every year. This is due to the well structured team work for reducing and intervening in the affairs of individuals who are likely to commit self harm. Prison Service stress the service of psychologists in the case of prisoners who undergo life sentences (Towl,G.J. 2003 p.1) The Department of Health and the Department of Education has made it mandatory for prisoners to undergo education. The education of prisoners and further developments are required to be reported to the Department of Education rather than to the Home Office. Similar emphasis is also made for prisoners to learn skills. The government is committed to provide education to prisoners. The Social Exclusion Unit report of 2002 demands the resettlement of prisoners not only to create a change in the criminogenically centre behavior exercise but also on practical policies to assist prisoners to earn work, support and accommodation from outside organizations. Reoffending and self harm is thus reduced as a result of the efforts of National Offender Management System (NOMS) that caters to the personal development of an individual. Prison managers have a great responsibility in achieving these objectives because they do not have direct access to the finance required to substantiate these policies (Jewkes, Y. 2007. p.3). HM Prison Service gives importance to treat inmates in a humane manner. The Prison service has a mission statement with regard to race relations which has to be followed by prisoners and prison staff. The chairman of race relations management group is Deputy Governor or Governor of Prison. Prison Service also has rules for anti-bullying governed by the anti-bulling coordinator. HM Prison also takes due care to protect individuals from self harm and this is managed by three individual bodies: The Internal Standards Audit Unit, the Independent Monitoring Board and the HM Chief Inspectorate of Prisons (Liebling, A. Maruna, S. 2005. p.150). In addition to Prison Services Citizen Prison Reform teams have dedicated their life to improve the quality of prisoner’s life in jail. Some of the renowned organizations are Howard League, the Fortune Society, John Howard Association, Prison Fellowship Ministries, Amnesty International and the Osborne Association. These organizations have played a key role in effecting a change to prisons in the twentieth century by campaigning for improved conditions and adequate resources though public intervention. These groups are give freedom to visit prisons and prepare report and have been adorned quasi formal position (Tonry, M. 2004 p.191). Prison Service permits normal health care services to prisoners which common people avail from the National Health Service. Elder prisoners also receive due care for their illness (Wahidin, A Cain, M. 2006 p.195). Private associations like Bridging the Gap (BTG) has been extending support to prisoners since 1970’s. BTG is registered charity with a dedicated team of unpaid staff who coordinate prison penpals in United States of America and Britain. BTG organizes workshops for prison service staff, inmates, and probation staff and for those interested in supporting prisoners (Bridging the Gap). The Inside Out Trust is engaged in developing prison projects for restoration of justice. Prisoners are given opportunity to learn skills and employ them to offer products and services to under privileged people around the world. This enables prisoners to recognize other needs and find satisfaction by helping them. The positive feeling out of such activities reduces the incidence of self harm (Welcome to the Inside Out Trust website). It may be concluded that Prison Services is actively involved in reduction, prevention and management of self harm in prisons. There has been considerable evidence of effect when proper guidance, engagement, health and mental care are provided to prisoners when they seem to take care of themselves and other inmates. Government interference for the care of prisoners adds to the responsibility of Prison Service to provide care and divert prisoners from committing self harm. Prisons have been generous in allowing private associations to solve the problems of inmates. This has resulted in a number of voluntary organizations working selflessly to provide support and guidance to prisoners. Reference Actions following an incident of self-harm. October 26, 2007. Available: http://pso.hmprisonservice.gov.uk/pso2700/PSO%202700_-_front_index_and_PSO_itself.htm#CHAPTER13. Accessed on November 4, 2008. Bridging the Gap. Available: http://www.btguk.org/html/history.htm. Accessed on November 4, 2008. Jewkes, Y. (2007) Handbook on Prisons. Devon: Willan Publishing Leech, M. & Cheney, D.2002. Prisons Handbook. Hampshire: Waterside Press Liebling, A. Maruna, S. (2005) The Effects of Imprisonment. Devon: Willan Publishing Planning and providing care for prisoners at risk of suicide and/or self harm. October 26, 2007. Available:http://pso.hmprisonservice.gov.uk/pso2700/PSO%202700_-_front_index_and_PSO_itself.htm#CHAPTER8. Accessed on November 4, 2008. Reducing Suicide and Deliberate Self Harm Exploring experience: a discussion process June 24, 2005 Available: http://openscotland.gov.uk/Publications/2002/07/15163/9363. Accessed on November 4, 2008. Resettlement Services 2004 Available: http://www.hmprisonservice.gov.uk/prisoninformation/locateaprison/prison.asp?id=8783,15,2,15,350,0. Accessed on November 4, 2008. Self Harm. Available: http://www.hmprisonservice.gov.uk/adviceandsupport/prison_life/selfharm/. Accessed on November 4, 2008. Suicide prevention and self-harm management for women prisoners October 26, 2007. Available: http://pso.hmprisonservice.gov.uk/pso2700/PSO%202700_-_front_index_and_PSO_itself.htm#CHAPTER12. Accessed on November 4, 2008. Suicide prevention and self-harm management for young people. October 26, 2007. Available: http://pso.hmprisonservice.gov.uk/pso2700/PSO%202700_-_front_index_and_PSO_itself.htm#CHAPTER14. Accessed on November 4, 2008. Summers, L. (n.d) Reducing Self-Harm and Suicide in Prisons: Advice for Prison Staff on Using Safer Cells. Available: http://www.jdi.ucl.ac.uk/downloads/publications/crime_science_short_reports/safer_cells.pdf. Accessed on November 4, 2008. The ACCT approach Available: http://www.hmprisonservice.gov.uk/assets/documents/10000C1BACCTStaffGuide.pdf. Accessed on November 4, 2008. Tonry, M. (2004) The Future of Imprisonment. Oxford: OUP Towl. G.J. (2003) Psychology in Prisons. Oxford: Blackwell. Wahidin, A Cain, M. (2006) Ageing, Crime and Society. Devon: Willan Publishing. Welcome to the Inside Out Trust website. Available: http://www.inside-out.org.uk/. Accessed on November 4, 2008. Read More