Self Harm And Suicide In Prison

Although specific explanations have been put forward by those attempting to explain self harm and suicide, they can each generally fit into one of two main larger theories. The first, that the individual characteristics of inmates themselves are explanatory variables and that their susceptibility to self-harm and suicide is essentially imported into prison. The second, that it is the environmental factors characteristic of prison which actually act as a causative link between prisoners and acts of self-harm or suicide. The ideas behind these explanations are informed by an even larger theoretical debate around how people adjust to prison generally; the two contrasting arguments are known as the importation and deprivation models.

The first point to examine is the validity of argument that individual characteristics are indeed what primarily predisposes prisoners to self-harm and suicide. Such arguments stem from the importation model, which supports the notion that prisoners already possess certain characteristics making them more likely to self-harm before they are even in prison. According to Irwin and Cressey (1962, p.145) “a clear understanding of inmate conduct cannot be obtained simply by viewing ‘prison culture’ or ‘inmate culture’ as an isolated system springing solely from the conditions of imprisonment.” The factors researchers have tended to focus on include; gender, age, psychiatric, history, offence-type, legal status and sentence length. Zamble and Porporino have outlined “adverse life events, negative interpersonal relationships, social and economic disadvantage, alcohol and drug addiction, contact with criminal justice agencies, poor educational and employment history, low self-esteem, poor problem-solving ability, and low motivational drive” (cited in Liebling,1995,p. 181) as the characteristics of prisoners which can be relied upon in identifying risk factors. In a recent study conducted by Humber et al (2011), prisoner characteristics of suicide victims were in England and Wales were examined. They suggested that amongst the prison population there are particular groups more likely to be suicidal. This included; female prisoners, those who have been identified as being at risk of self-harm/suicide, those with a psychiatric illness and those with a history of violence.

As has been discussed above, a vast amount of international research on prison suicide and self-harm has sought to understand this behaviour through focussing in on the individual characteristics of inmates. Due to the fact causes of suicide have been so strongly aligned with personal attributes of prisoners, public policy has often been structured with an emphasis on the prediction, prevention, and treatment of suicidal prisoners (Hayes ,1999). However, in focussing solely on the prisoners alone ignores a significant component of prison and that is the harsh environment and constraints which it enforces upon inmates. If the notion of imported vulnerability is relied upon in explaining suicide, it is assumed that one already exhibits certain traits before they were put in prison, such an assumption raises several questions of doubt. Prison suicide rates are commonly compared with those of the general population and this has highlighted that prisons have a higher number of suicides relative to their population than that of mass society. It must be asked then if people already have certain characteristics before they get to prison then what is that leads them to suicide in prison and not in the outside world. The importation model also fails to explain those who have previously never suffered mental illness or any characteristic associated to being susceptible to suicide, but yet once imprisoned begin self-harming or even commit suicide. Rather than thinking of suicide as an individual issue, perhaps it should be approached from an institutional perspective which looks to its own walls for answers and not just at those who inhibit it.

Liebling (1995, 1999) has repeatedly emphasised that concentrating studies exclusively on the individual is conceptually limited and she has stressed the need to approach prison suicide from an institutional perspective. Such discourse aligns with the deprivation model of thinking, originating from the work of (Clemmer,1940), (Goffman,1961) and (Sykes,1958). The deprivation model purports that it is the “pains of imprisonment” or deprivations suffered in prison, that primarily influences ones response to imprisonment. Sykes (1958) described; deprivations of security, autonomy, sexual desire, liberty, and goods and services as being central to the construction of such an environment. He suggested that “prisoners could display self-centred and egotistical alienative modes of behaviour that arose from being forced to conform to roles commensurate with prison regimes and having to fit in with prison social life”( Sykes,1958 p.295). More recently, De Viggianni (2007) and Ireland (2000), have also looked into incarceration and consequential suicidal behaviour. They drew correlations between such behaviour and the socio-environmental factors specific to prisons such as, a lack of support the presence of gang culture, and the prison code and its enforcement.

It would therefore appear that the deprivation model is proposing that the more severe the consequences of the institutional regime are, the greater the likelihood of suicide occurring in prison. Huey and Mcnulty (2005) drew the conclusion that it is overcrowding so commonly experienced by prisons which plays a pivotal role in deprivation and consequently on prison suicide. A prison which is overcrowded and under staffed is undeniably more likely to have a decrease in standards. Services such as medical care, and unfavourable dynamics like staff-offender ratio, limited activities, a lack of food and clothing, unwanted interactions, and fluctuating social structures within the prison can all stem from overcrowding and all contribute to an increased risk of self-harm and suicide (Anasseril,2006). Liebling’s (1992) study, involving interviews with prisoners who had attempted suicide whilst inside indicated that a prisoner’s vulnerability to suicide is also extremely relative to the support and contact received from family and friends on the outside. She found that a scarcity of visits, written communications, and contact with community release/probation programs can detach a prisoner from the outside world and thus induce self- harming acts. She has also associated the use of time and opportunities available to prisoners with the likelihood of suicide. Believing that the ways in which inmates serve their sentences, can dramatically affect their mental state, she highlights inactivity as a crucial aspect of this. In New Zealand, the prison population is approximately 8698 people, with the imprisonment rate having increased by 53% in the last decade. (Department of Corrections, 2012a). Within his work calling for prison reform, Director of Rethinking Crime and Punishment, Kim Workman has alluded to the importance of values in prison. He suggests New Zealand needs to create a “humane, just and workable prison system that attempts to reduce the pain of imprisonment”(2009,p.18) and if a move can be accomplished from managing risk to creating a system supporting inmates to achieve their best, then that will be a major achievement.

Although of course all prisons vary and some more than others would display the institutional paradigms as discussed above. Evidence suggests that prisons generally are lacking, at least on some level in providing the services needed and to the extent needed to ensure the health and well being of prisons is addressed and thus suicidal behaviour is reduced. What deprivation based theories could be critiqued in ignoring though, is that the prison environment can in some instances have a positive influence on inmates and work in improving people’s lives, leading them away from self- harm and suicide. In New Zealand numerous programmes exist to enhance the rehabilitation of prisoners, including; motivational programmes; rehabilitation programmes; education and employment programmes; and reintegration programmes. A recent example of the success these programs occurred this month when a group of prisoners at Auckland Region Women’s Corrections Facility were the first to graduate from the Small Motors Engineering course(Department of Corrections,2012b). Additionally, just as the importation model can be critiqued for its failure to see the prison itself as a problem, the deprivation model could arguably be seen to not fully engage the personal traits of the individual inmate.

It would appear that the deprivation and importation models are rarely considered in unison, however it is beginning to become acknowledged that an integrated model of prison suicide could be the most sufficient method of furthering research and consequently preventing self-harm and suicide (Dear, 2006; Liebling,2006; Towl, Snow and McHugh, 2001). Through considering both models simultaneously a more and realistic and practical grasp on the occurrence of suicide can be ascertained, as more often than not both the environment somebody is confronted with and their own personal traits act combine together in influencing their resulting behaviour and well-being.

Preventing Suicide

Throughout research attempts, no one trigger has been able to conclusively identify the reasoning behind why people commit suicide in prison. It can thus be assumed that no single solution will successfully achieve the goal of suicide prevention and a multi-disciplinary approach is required if an effective outcome is ever going to be reached. In conjunction with this there must be a commitment from the prison and department to actually adopt and apply prevention strategies, because no matter how complete a strategy may be, it is worthless without implementation.

In looking to the research which has been done on suicide prevention, it has been found that when comprehensive prevention programs have been implemented considerable decreases in suicides and suicide attempts have been accomplished (Cox and Morschauser, 1997, Gallagher and Dobrin, 2005; White and Schimmel, 1995). It must be noted however that the specifics of these programs should be relevant to local resources and inmate needs, for example a prevention program designed in America for a maximum security prison would not have a positive preventive effect if enforced on a smaller medium security prison in New Zealand. Konrad et al, 2007 have comprised an outline of several key components they believe necessary to any prison suicide prevention strategy. The first aspect outlined is training, specifically of correctional officers whom are the ones with the inmates on a constant basis, mental health professionals will never be available at all times to all prisoners and thus officers must be trained to develop an intuitive sense about the mental state of the inmates under their care. Training must also be kept constant, they suggest at least once a year. Screening is the second preventative tool they refer to. Suggesting that screening should take place immediately as they inmate arrives and if possible screening should be carried out within the context of an intake medical and psychological assessment, conducted by relevant professionals. Where it is the responsibility of correctional staff they should have specific training. Communication is also a vital factor and records of such screening should be kept so as all staff can become aware of at risk prisoners and not just the one person who did the screening. If a prisoner identifies as high risk this should not be ignored and immediate professional help should be provided. They stress that screening should not just be a one off measure, but must take place regularly to be effective as suicide prevention involves on-going observation. If an inmate has been recognised as suicidal, Konrad et al emphasise that they should not be left alone and adequate monitoring is essential as suicide can happen within minutes. They further the importance of human contact by including social interaction as a key preventative aspect. Referring to the success of a social support system which has been provided through the use of specially trained inmate “buddies” or “listeners”. In terms of the more physical elements of the prison itself the authors outline that a suicide-safe environment is necessary.

In building on these key components, it is also necessary to consider the prison atmosphere in general in relation to the pressures and harsh mentality it exerts. Prison has been described as an “intrinsically non-therapeutic environment” (Department of Corrections, 2008), yet we are frequently sending people there who exhibit severe mental illnesses and numerous other vulnerabilities. Of course some people are a danger to society and it cannot be expected that these people are simply excused from prison due to certain characteristics, however, the environment inmates are living in, could be changed. Instead of focussing on locking people up with no stimuli’s or contact with others, the focus should be on giving prisoners the chance to change and we cannot expect this from taking everything away from someone. Just by being in prison one has given up any liberties and power but by taking away even the smallest of luxuries like the ability to exercise or go outside or even have a pen and paper is not only depriving but also preventing growth within that person. Self-harm and suicide will inevitability continue to occur if people are completely deprived of any sort of life except simply existing within four walls. The system must gain the ability and willingness to identify the vulnerability of each prisoner, provide the necessary supervision and support, and create an atmosphere in prison where the opportunity exists to cope with and reduce emotional distress which commonly develops into self-harm or suicidal behaviour

Conclusion

This paper has considered the concerning issue of self-harm and suicide in prisons. Numerous existing explanations for this behaviour have been explored within the two main theoretical spheres of the importation and deprivation models. The latter part of this essay has focussed on possible preventative strategies aimed at counteracting the causative factors forming the varying explanations for self harm and suicide. In drawing all the components of this paper together, prison is a place which comprises of a number of more vulnerable population groups coupled with an environment which is more commonly designed to be harsh, punitive and for adult men who are sound in body and mind. This combination of factors ignores who is really in our prisons and fails to aid the aims of prisoner safety and rehabilitation. As a result of these imbalances, self-harm and suicide occurs and in order to combat this, an environment which offers more than the luxury of just existing must be sought.