Self Harm and Suicide in Women Prisons - Coursework Example

Self harm and suicide in women prisons The essay will focus on the self-harm and suicide in women prisons. Various research studies have been conducted and shown that more women tend to commit suicide while in prison than men do. In the United Kingdom, women prisons have recorded a significant numbers of female prisoners who commit suicide or harm themselves while in custody. The increasing numbers of deaths because of suicide in prisons has raised an alarm on governmental, non-governmental, and international organizations have raised heir alarm on the increasing figures. Suicide and self-harm can be prevented if adequate diagnostic and preventive measures are taken into consideration. In the United Kingdom, all stakeholders are working together to reduce the death related cases in the women prisons which are on the rise since 2009. Self-harm and suicide are caused by a number of factors. The factors may be biological, genetic, and environmental. The way, in which these factors interact and lead to a suicide, is still unknown. TABLE OF CONTENTS Abstract ……………………………………………………………………………..…..2 Introduction…………………………………………………………..……..….…….….4 Discussion…………………………………………………………………………….….5 Conclusion………………………………………………………………………………10 References……………………………………………………………………………....11 Appendix…………………………………………………………………….……….....13 Introduction Self-harm occurs through injuring or poisoning that is done by an individual irrespective of the motivation that is involved. This involves self-injury through cutting oneself or poisoning through medication (National Institute for Health and Care Excellence (NICE), 2014). According to the Health and Social Care Information Centre 4.9% people in the United Kingdom, had harmed themselves in one-way or other. Statistics shows that in 2012, there were 11.6 deaths per 100,000 people (NICE, 2014). In English and Welsh prisons, the deaths resulting from self-harm were eight times higher. Moreover, research has also shown that people who have self harm, have a high likelihood of committing suicide within a period of twelve months. Additionally, the research has also shown that inmates, who commit suicide, have a history of self-harm in their lives. Consequently, NICE has a management plan both short term and long-term on how to handle people 8 years or older who self harm themselves. On long-term management, it covers psychological or a single and recurrent assessments. According to the assessment guidelines, there is a recommendation to the health care professionals that people, who have self-harm, may also commit suicide. On the long-term management efforts, it covers psychological treatment and efficient treatment of recurrent cases. There were 139 out of 195 individuals self-harmed within a period of six years (NICE, 2014). This translates to an annual self-harm from 200 to 249 people per 1000 each year. Additionally, statistics also show that of individuals that self harmed 20-24% were female prisoners (NICE, 2014). These numbers are high despite the small number of female prisoners. Moreover, women who self harmed, did so eight times a year compared to the men who did so twice a year. Discussion In the UK, self-harm is one of the issues that affect women prisoners. Women prisoners in the UK make 5% of the total prisoners in the country despite the small number of female prisoners in the UK (BBC News Health, 2013). According to the Oxford University researchers, Women prisoners account for half of self-harm reported cases. The research studies published by the Lancet show that almost a quarter of female inmates poison or scratch themselves (BBC News Health, 2013). Self-harm has also been implicated to be risk factors among males, but more female cases have been reported compared to those of males. According to the research study conducted by Oxford University in Prisons in Wales and England between 2004 and 2009 shows that about 5% to 6% of the male prisoners harmed themselves compared to 20% to 24% of the female prisoners and this amounted to 20,000 to 25000 incidents each year. Additionally, these figures translate to about 0.6 % of the total population in the United Kingdom (BBC News Health, 2013). Moreover, according to the Andy Bell Centre for Mental Health, overdosing and poisoning were frequent amongst women while scratching and cutting were frequent methods used by men to harm them. The research also points out that prisoners on the age of 20s who were serving life sentences make the highest percentage of those women who harm themselves. The research concludes by pointing out that life sentences were the main risk factors (BBC News Health, 2013). Of the six billion people globally, 10 million of people are prisoners and there is little information from each country on the conditions in which prisoners are held. From the above perspective, likelihood exist that prisoners suffer from high levels of mental problems. Suicide has been the major cause of death in prisons globally with the mortality rate more that three times higher as compared to free people (The Lancet, 2014). Female prisoners attempt suicide in the early days after their reception in the prison and on global statistics has shown that self-harm is common with women. The revelations written on The Lancet by Keith Hawton have given an insight of the risk factors to self-harm in prisons. Additionally, of the 26,510 incidents of self-harm that occurred in Wales and England, 5-6% of the cases were females, and 20-24 cases were females. Furthermore, self-harm was common in women inmates of the white ethnic origin with life sentences (The Lancet, 2014). According to the findings, there is an importance to make a quick intervention after the incidents of self-harm to bar future instances. The preventive measures had found their way into the England and Wales prison services. The government of England and Wales have witnessed a reduction in the deaths related to self-harm from 96 in 2004 and 60 in 2012 after implementing several initiatives (The Lancet, 2014). Some of the initiatives include enhanced mental health services (The Lancet, 2014). Furthermore, to curb the situation, there has been a multiagency collaboration with all stakeholders to curb the rising cases of suicide. In addition, prison officers have also been equipped with the important information on the various preventive measures for suicide and self-harm. In this situation, prison officers have been equipped with the necessary information that has assisted in calming, managing, and identifying high risk cases. Additionally, focus has also been drawn to train an effective specialists and systems now available in the UK. Despite the efforts in preventing suicide and self-harm by the prisoners in the UK more work still needs to be done (The Lancet, 2014). Samples that were taken from the ground when linked to the epidemiological samples it is not easy to come up with conclusions. Research needs to be done to differentiate between complete suicide and suicidal ideation (The Lancet, 2014). Moreover, more investment needs to be done to include all people on the ground to pay close attention to the distressed prisoners to help them when in need. Suicide is a multifaceted issue that has attracted the attention of many specialists around the globe. The problem has attracted the attention of everyone, but control and prevention are not easy. Prevention of suicide calls for a multifaceted approach. This can be done through handling of mental illnesses and control of the environmental risk factors (World Health Organization, 2007). Moreover, introduction of the suicide prevention programs and provision of adequate information and awareness are essential for the control of the suicide related cases (World Health Organization, 2007). The causes of stress are complex to comprehend, but individuals faced with different difficulties in life are vulnerable to suicide. Consequently, to reduce cases of suicide people who are most vulnerable should be identified, and adequate intervention methods identified and applied effectively. Researchers have identified a number of factors that lead to suicidal cases, and they include biological, socio cultural, psychiatric conditions, social stress, and genetics. However, the interaction of the processes, to produce stress, is yet to be understood (World Health Organization, 2007). Furthermore, these factors have helped to determine the groups that are most vulnerable to the suicidal cases. People, who are vulnerable to suicide, include the old people, those in custody, indigenous people, and persons with mental illness, persons with alcohol or substance abuse and the young males. Inmates have shown the highest rates in suicide as compared to individuals that are free (World Health Organization, 2007). Most people, who have been imprisoned, show suicidal symptoms in their lives (World Health Organization, 2007). Any combinations of individual and environmental factors have accounted to the high suicidal rates in the correction facilities. Additionally, research has shown that women in custody have shown more signs of committing suicide than their counterparts in the community. Since women have the poor social and family support prior to any suicide attempt, diagnosis should be directed towards their social problems and psychiatric illness for suicide prevention programs. In 2011, the National Service Framework for Mental Health Services, launched a framework to curb the rising cases of suicide amongst inmates in the UK prisons. Some of the policies implemented in the framework include promoting health and working together with communities, promoting quality mental care to the people more especially the prisoners (Faulkner & Bird, 2014). Additionally, ensure that people with needy mental problems are placed in intense care around the clock. There is also need to work with the local prisons and the prison staff members to prevent suicide cases amongst the prisoners. Finally, there is need to make a regular local audit of suicide related cases and adequate measures taken to prevent future occurrences (Faulkner & Bird, 2014). The other study has focused that few studies have been conducted on female suicides due to their small number in prisons. However, it indicates that suicides among females are more pronounced (Faulkner & Bird, 2014). In estimation, almost half of the female inmates have made an attempt to commit suicide before. Amongst the population of women, a high level of psychological distress and distress manifests amongst the female prisoners. Research has also shown that women also desire to discuss their problems on the desire to die or to harm themselves. Various approaches have been undertaken to measure suicide attempts. Smith, Conr and Ehler formulated the most prominent one. They made a scale of called Suicide Attempt Rating Scale (LSARS) that is used to measure suicide attempts. The scale has been important in the measurement of the severity of the different methods used and the circumstances surrounding the attempts. However, the scale may not be applicable in the prison environment because it may be biased in the fact that the prison environment may not be equipped with full access of lethal arsenal (DaigleAlarie & Levebure, n.d). The research by the LSARS concludes by pointing out that suicide attempts by women are one of the ways of raising their grievances for help. Observers have pointed out that the incidents of self-harm are on the rise. According to the government statistics, it has revealed that 10,446 cases were reported between 2009. Consequently, the cases rose to 12,663 in 2013. The statistics further reveals that women prisoners, who harmed themselves, rose to 13,000 that culminate to 35 women in a day. There were only 4,100 women in prison and the incidents of self-harm amongst women account for a big percentage (The guardian, 2012). The research concludes by depicting that six every ten women, who are sent to Styal facility, have mental problems. As a result of the increased cases of women committing suicide in prisons, there has been increased supervision on the facilities due to the growing concerns that those admitted could be mentally ill. There are various suicide prevention strategies that clinical staff, administrators and the clinical staff should give a priority in every prison. In these situations, the correctional staff, medical staff, and the mental health should be well trained on how to handle a mental case. There should be the implementation of the suicide risk program that can help handle high-risk individuals. The most commonly used program is the Multi-Dimensional Risk Assessment that can be used to identify high-risk inmates upon their arrival (Anasseril, 2015). Moreover, upon identifying the high-risk individuals, they are given risk scores like one, two and three that help the caretakers to track the individuals with high risks. Conclusion In conclusion, self-harm has been a common trend in the UK prisons. Research has cited the number of factors that contributes to self-harm from biological, psychological and socio factors. Moreover, women in the United Kingdom make the largest percentage of people who self harm while still in prison. There have been concerns on the growing figures of people who harm themselves while still in custody. Since different governments in various parts of the world handle their prisoners in secrecy, not much is known on the environmental conditions of prisoners. Furthermore, research has also shown women in the UK makes the largest percentage of the people who harm themselves despite their small number compared to that of men. Self-harm cases could be controlled if all stakeholders put adequate diagnostic measures in place. References Anasseril, E, D, 2015. Preventing Suicide in Prison: A Collaborative Responsibility of Administrative, Custodial, and Clinical Staff.. [Accessed on 9th Jan 2015]. BBC News Health, 2013. Self-harm four times more likely in female prisoners. News Health. [online] . [Accessed on 8th Jan 2015] Daigle, M, Alarie, M and Levebure P, n.d. The Problem of Suicide Among Female Prisoner. Available at .[Accessed 9th Jan 2015]. Faulkner, A and Bird L, 2014. Suicide and self harm. Mentalhealth.org. . [Accessed on 8th Jan 2015]. National Institute for Health and Care Excellence, 2014. Self harm and Suicide in Prisons. . [Accessed on 9th Jan 2015]. The Lancet, (2014). Preventing self-harm and suicide in prisoners: job half done. Vol.383, No. 9923. P.1109–1111. The guardian, 2012. Women prisoners: self-harm, suicide attempts and the struggle for Survival. The Guaedian.com. < http://www.theguardian.com/society/2012/feb/11/women-prisoners-suffering-mental-health>. [Accessed on Jan 8th 2015]. World Health Organization, 2007. Preventing Suicide in Jails. International Association for Suicide Prevention. Available at: [Accessed 8th Jan 2015], http://www.who.int/mental_health/prevention/suicide/resource_jails_prisons.pdf. Appendixes Office of National Statistics, (2012). Suicide rates in the United Kingdom, 2006 to 2010. .[Accessed on 10th Jan 2014]. Suicide rates - Tables Table 1. Male suicide rates: by country and region, United Kingdom, 2006 to 2010 Rate per 100,000 population Country/Region 2006 2007 2008 2009 2010 United Kingdom 17.4 16.8 17.7 17.5 17.0 England 15.4 14.9 15.8 16.1 15.1 North East 17.5 17.0 17.8 19.2 16.9 North West 18.3 18.5 17.7 19.8 17.4 Yorkshire and The Humber 15.3 16.3 17.0 15.4 13.6 East Midlands 14.9 15.2 14.0 15.2 13.5 West Midlands 14.6 12.9 17.1 15.8 15.4 East of England 14.1 14.3 15.9 13.7 14.9 London 14.6 13.3 14.3 13.6 14.0 South East 14.7 13.9 15.0 15.9 14.6 South West 17.1 14.5 15.8 18.9 17.6 Wales 19.4 20.3 17.1 17.4 19.3 Table source: Office for National Statistics Table notes: 1. The National Statistics definition of suicide is given below under Definition. 2. Figures are for males aged 15 years and over. 3. Rates per 100,000 populations standardized to the European Standard Population. 4. Deaths of non-residents are included in figures for the UK but excluded in figures for England, Wales and Regions. 5. Figures are for deaths registered in each calendar year. Table 2. Number of male suicides: by country and region, United Kingdom, 2006 to 2010 Number Country/Region 2006 2007 2008 2009 2010 United Kingdom 4,196 4,085 4,331 4,304 4,231 England 3,131 3,043 3,263 3,330 3,165 North East 177 169 180 194 172 North West 491 498 478 538 479 Yorkshire and The Humber 311 335 353 321 286 East Midlands 263 271 250 270 239 West Midlands 310 273 365 336 334 East of England 311 318 365 321 352 London 437 410 444 431 434 South East 483 464 498 530 500 South West 348 305 330 389 369 Wales 223 232 195 201 225 Table source: Office for National Statistics Table notes: 1. The National Statistics definition of suicide is given below under Definition. 2. Figures are for males aged 15 years and over. 3. Deaths of non-residents are included in figures for the UK but excluded in figures for England, Wales and Regions. 4. Figures are for deaths registered in each calendar year. Table 3. Female suicide rates: by country and region, United Kingdom, 2006 to 2010 Rate per 100,000 population Country/Region 2006 2007 2008 2009 2010 United Kingdom 5.3 5.0 5.4 5.2 5.3 England 4.8 4.4 4.7 4.8 4.7 North East 4.7 4.3 4.9 4.0 5.7 North West 5.2 4.9 4.7 5.9 4.7 Yorkshire and The Humber 4.2 4.1 4.5 3.6 4.3 East Midlands 5.1 4.0 4.6 5.3 4.6 West Midlands 4.6 4.0 4.6 4.7 4.9 East of England 4.7 4.3 5.1 4.2 3.8 London 4.7 4.4 4.6 4.4 4.4 South East 5.3 4.4 4.6 5.2 5.0 South West 4.8 4.8 4.9 5.7 5.7 Wales 6.3 4.3 5.8 4.3 4.6 Table source: Office for National Statistics Table notes: 1. The National Statistics definition of suicide is given below under Definition. 2. Figures are for females aged 15 years and over. 3. Rates per 100,000 populations standardized to the European Standard Population. 4. Deaths of non-residents are included in figures for the UK but excluded in figures for England, Wales and Regions. 5. Figures are for deaths registered in each calendar year. Table 4. Number of female suicides: by country and region, United Kingdom, 2006 to 2010 Number Country/Region 2006 2007 2008 2009 2010 United Kingdom 1,358 1,292 1,375 1,371 1,377 England 1,044 950 1,019 1,060 1,035 North East 51 47 52 43 63 North West 145 139 135 167 137 Yorkshire and The Humber 91 90 99 80 94 East Midlands 95 73 83 103 84 West Midlands 101 89 101 110 116 East of England 113 104 124 102 93 London 151 139 147 139 140 South East 186 158 166 191 182 South West 111 111 112 125 126 Wales 77  57 71 57 63 Table source: Office for National Statistics Table notes: 1. The National Statistics definition of suicide is given below under Definition. 2. Figures are for females aged 15 years and over. 3. Deaths of non-residents are included in figures for the UK but excluded in figures for England, Wales and Regions. 4. Figures are for deaths registered in each calendar year. Read More