To date, little research has systematically investigated perceptions of mental health professionals regarding motivations for self-injury among prison inmates. To help fill this gap, the authors used descriptive techniques to examine self-injurious behavior among inmates from the perspective of correctional mental health professionals. A quantitative survey assessed perceptions of mental health staff regarding etiology, motivations, and manifestations of self-injury. A qualitative interview component was used to explicate responses from the survey. Inmate cutting, scratching, opening old wounds, and inserting objects were the most commonly witnessed behaviors. Findings suggest that self-injury occurred regularly and that a subset of inmates are responsible for recurrent events. Mental health professionals perceived the motivation for inmate self-injury to be both manipulative and a coping mechanism. They described current management strategies and corresponding needs for training and resources.

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Institutional Responses to Self-Injurious Behavior Among Inmates:

Objectives. To further understanding of how health and correctional staff responses to self-harming behaviours influence prisoners and their subsequent actions. Design. Participant-centred, qualitative methods were used to explore the complex and under-researched perspectives of self-harming male prisoners. Method. Semi-structured interviews were conducted with 20 adult male prisoners who had engaged in repetitive, non-suicidal self-harm during their current prison sentence, or considered doing so. The interviews were analyzed drawing on principles of thematic analysis and discourse analysis. Results. With some exceptions, prison officers, nurses, and doctors are portrayed by prisoners as being ill-prepared to deal with repetitive self-harm, often displaying actively hostile attitudes and behaviours. Conclusions. These findings underscore the need for appropriate training, support and supervision for staff working with self-harming prisoners. Language: en

The impact of prison staff responses on self-harming behaviours: Prisoners’ perspectives

This paper presents material from extended interviews and observations with 25 street youth in Mexico, revealing how their attempts to control and understand their lives relies on a control of and identification with their bodies. Using Goffman's ideas of stigma and performance, and Butler's performativity, the paper illustrates that even if these young peoples' bodies fall short of mainstream ideas for youthful bodies, they have developed some strategies that allow some control over their bodies. These bodily performances differ according to audience. This intention is by no means fully achieved. Their bodily actions sets out a series of identity markers but street life implies all sort of events, from painful childhoods to vicious leisure pursuits, and restricts the ability to affect material conditions. Moreover, care needs to be taken in interpreting these signs as the participants' own understandings and practices are neither easily categorized nor consistent.

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Bodies on the line: identity markers among Mexican street youth

Male prisoners with (n = 132) and without (n = 132) histories of engaging in self-injurious behavior (SIB) were matched on conviction prefix and custody level. Conditional logistic regression revealed that a combination of risk factors from domains defined by developmental, offense history, mental health, and institutional functioning factors correctly classified 93% of the prisoners in the sample (ROC AUC = 0.89, S.E. = 0.005, p < 0.0001). Model specificity was 92.6% and sensitivity was 95.3%. False positive and false negative rates were 2.3% and 3.4%, respectively. Implications for the assessment of prisoners at risk for SIB as well as suggested future directions for SIB prisoner research are discussed.

Identification of risk factors for self-injurious behavior in male prisoners

This study examined the association of extent of prisoner self-injurious behavior (SIB) and placement in long-term maximum-security administrative segregation. A prisoner subgroup (n=132) defined by extent of SIB was matched by conviction prefix and security level to a group of prisoners who had never engaged in SIB (n=132) and compared on selected variables. Relative to prisoners who either engaged in less extensive SIB or none at all, prisoners who engaged in three or more forms of SIB while in prison were found to be twice as likely to be housed in long-term administrative segregation, less educated, began their criminal careers at an earlier age, engaged in more violence in the community and in prison, involved in property destruction, and experienced a much greater degree of housing instability in prison.

Are the “Worst of the Worst” Self-Injurious Prisoners More Likely to End Up in Long-Term Maximum-Security Administrative Segregation?

Although self-injury is not a new behavior, public awareness of it has increased dramatically since the mid-1990s (Adler and Adler, 2005). Selfinjury is generally defined as the deliberate act of physically hurting oneself, usually without conscious suicidal intent, in a manner that results in superficial, rather than traumatic, damage to body tissue. Despite typically being perceived as psychological in nature (Favazza, 1998; Muehlenkamp, 2005), the etiology is not often clear. The bulk of selfinjury behavior (SIB) research comes from a mental health perspective, rather than from sociology or related disciplines; yet the DSM IV (1994) says little about SIB, other than listing it as a symptom for other “disorders.” Clinically, self-injury consistently has been linked to a broad range of individual-level problems, ranging from intellectual and developmental difficulties to emotional dysfunctions, and to physical and behavioral maladaptation. Such typologies reduce the act to individual pathology rather than, as Kilty (2006) notes, a possible coping mechanism in a debilitating environment. Estimates of the prevalence of self-injury in the non-prisoner population are inconsistent, varying from 1% to 4% and between 12% to over 40% among adolescents and college-aged samples (Muehlenkamp, 2005; White Kress, 2003). One of the few common claims across studies is that selfinjury typically begins during early adolescence and tends to persist for an average of 10 to 15 years, although it may continue for decades (Favazza, 1998; Muehlenkamp, 2005).

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Steve Kazmierczak

Papers

Self‐injury in correctional settings: “pathology” of prisons or of prisoners?*