Lessons Learnt from the Narratives of Women who Self-Harm in Prison

Background In England and Wales, women in prison make up a minority (4.7%) of the total custodial population, yet acts of self-harm are around five times more common in incarcerated women. Whilst there has been a multiagency effort to improve how acts of self-harm are documented across prisons, the patterns and functions for women in prison who self-harm have not yet been fully addressed
Aims To determine patterns, prevalence, and functions of self-harm among women in prison through a mixed-methods study
Method 108 women with a history of self-harm were interviewed across three closed female prison sites. Participants completed a structured questionnaire detailing their experiences of self-harm across prison and community settings.
Results We found that women in prison who frequently self-harmed disclosed high levels of trauma, with regards to past experiences of domestic violence (81.5%), childhood sexual abuse (66.7%) and adult sexual abuse (60.2%). Prevalent methods of recent in-prison acts of self-harm involved cutting, followed by ligature and self-strangulation.
Limitations The study utilised cross-sectional design, self-reported data, and featured a subset of women identified at high-risk of self-harm.
Conclusion Motivations behind acts of self-harm in forensic environments are complex. Important predisposing triggers included: intrapersonal and environment conflict, deteriorating mental health, and separation from children or family.