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Abstract
This study considers how those who work in prisons are affected by and respond to
repetitive self-harm of imprisoned women in English prisons. This paper considers the
perspectives of custodial staff working in this area on a day to day basis. Semi-structured
face-to-face interviews were conducted with 14 prison staff and explored using techniques
of thematic analysis. The interviews examined: the emotional impact of working with and
witnessing self-harm incidents, coping strategies used, training and the support available to
prison staff. Findings indicate the strategies used by staff to cope emotionally with such
incidents and these include presenting a ‘façade of coping’, rejecting support, and becoming
desensitized. It is concluded that staff felt they must portray themselves as coping well with
self-harm in prison even when they were troubled and emotionally affected by it. However,
some did describe accepting help when outside of the prison and this has implications for
how support can be offered in the future. It is recommended that more should be done to
support and train staff in this area.
Key words: Prison staff, suicide, self-harm, women, training, qualitative
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Introduction
Investigating the views and perspectives of professionals and service providers is a very
important, but regularly ignored component when studying repetitive self-harm. This is
often the case in the criminal justice system, especially prisons, where the incidences of self-
harm are high (Ministry of Justice, 2014), and prison staff have daily contact with self-
harming prisoners. Professionals dealing with self-harm often experience a range of worries,
anxieties and difficult emotions which they must deal with (Taylor, Hawton, Fortune, &
Kapur, 2009). Previous research has illustrated that the negative emotions that professionals
often have in this area are not only problematic for the staffs own psychological well-being.
But can also be harmful for their relationships with individuals under their care and may also
have negative consequences towards these relations too. (Marzano, Ciclitira, & Adler, 2012).
As a result of this, people who repeatedly self-harm have been found to limit their contact
with services due to their experience of unfavourable, unsympathetic and stigmatizing
attitudes of staff (James, Bowers & Van Der Merwe, 2011).
Research into the specific impact of self-harm in custody on prison staff is limited
(Marzano, Adler and Ciclitira, 2013; Walker, 2015; Walker et al, 2016a; Walker et al, 2016b);
but some parallels can be drawn between the experiences of prison staff and professionals
working in traditional healthcare settings (Short et al., 2009; Marzano, Adler and Ciclitira,
2013). Some healthcare professionals have viewed self-harm as attention seeking and
‘manipulative’ (Patterson, Whittington and Bogg, 2007; Short et al., 2009), while some staff
have reported frustration, distress and helplessness when working with individuals whom
they perceive to have harmed themselves for ‘non-genuine’ reasons (McAllister et al., 2002).
Some professionals develop antipathy towards self-harming individuals in their care,
attributing the cause of the behaviour to the character of the individual (Huband and
Tantam, 2000); and developing the belief that treatment for self-harm is futile (Friedman et
al., 2006; Patterson, Whittington and Bogg, 2007), particularly if self-harm is perceived as
repetitive and of low severity (Stanley and Standen, 2000). Similarly, many prison staff,
including prison healthcare staff (Marzano, Adler and Cicltira, 2013), report feeling
insufficiently trained to manage prisoners who self-harm, and thus powerless to support
them (Towl and Forbes, 2002; Short et al., 2009; Moses, 2013; Walker, 2015; Walker and
Towl, 2016a). Prison staff have reported feeling bullied into demonstrating concern for
prisoners who self-harm (Pannell, Howells and Day, 2003; Short et al., 2009; Marzano, Adler
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and Cilicitira, 2013). This can lead to prison staff becoming resentful, ultimately causing a
reduction in willingness to support prisoners who self-harm or even to reprimand them for
their behaviour (Pannell, Howells and Day, 2003; Kenning et al., 2010; Marzano, Adler and
Ciclitira, 2013).
Current measures to support prison staff are limited (Justice Committee, 2009;
Moses, 2013; Walker, 2015; Walker and Towl, 2016; Walker et al, 2016b). Presently, after
experiencing self-harm prison staff must be given information on, and assessed for
symptoms of post-traumatic stress; offered a post-incident debrief; and referred to the
prison Care Team (prison staff who, in addition to their regular duties, provide confidential
peer support service to colleagues following a traumatic incident) (NOMS, 2010b). Traumatic
incidents are defined as exposure to the violent death of a prisoner; being assaulted by a
prisoner; being taken hostage by a prisoner; or subjected to the real threat of violence
(NOMS, 2010b). This definition has been criticised for failing to consider the cumulative
effects of frequent, ‘minor’ incidents, or the effect of the individual officer’s relationship with
the prisoner involved (Justice Committee, 2009). Prison staff with a professional healthcare
qualification are usually required to have clinical supervision to practice (Dickson-Swift et al.,
2008). This supports job performance and self-development (McMahon and Patton, 2002),
and enables staff to identify and cope with any workplace stress (Dickson-Swift et al., 2008).
This is not however a requirement for prison officers (Moses, 2013; NOMS, 2015).
Personal characteristics have been shown to have an effect on the impact that
involvement in incidents of self-harm can have on prison staff (Wright et al., 2006).
Optimism and sense of control are linked to symptoms of traumatic stress; and higher stress
levels are linked to lower levels of perceived helplessness and avoidance (Wright et al.,
2006). Wright et al. (2006) suggest these counter intuitive findings could be explained by the
degree to which an individual’s optimism and sense of control represent unrealistically
positive expectations; and similarly, that a low sense of helplessness and avoidance suggests
the belief that they should have been better able to manage a difficult situation. Previous
experience of self-harm in custody is linked to higher trauma in subsequent incidents
(Wright et al., 2006). In some cases, involvement in a death in custody can lead to the
development of post-traumatic stress disorder (Wright et al., 2006). The ways in which
prison staff and health care staff deal with these pressures remain ambiguous and may be
multi-faceted. Although limited, the research on how prison staff approach their work seems
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to propose that they cope by rejecting or become emotional distanced from the prisoner
(Huband and Tantam, 2000); avoid responsibility (Short et al., 2009); have increased alcohol
consumption (Short et al., 2009); avoid difficult shift patterns (Marzano, Adler and Ciclitira,
2013); and have emotional blunting (Marzano, Adler and Ciclitira, 2013). These coping
strategies are largely ineffective for both managing stress and improving job satisfaction
(Mackay et al., 2004; Liebling et al., 2005).
The present study
Each year, it is estimated that 20% – 24% of imprisoned women in England and Wales self-
harm, compared with 5% - 6% of male prisoners (Hawton et al., 2014). Imprisoned women
are more likely to harm themselves repeatedly, approximately 8 times per year; whereas
imprisoned men self-harm approximately twice per year on average (Hawton et al., 2014).
The number of self-harm incidents by women in custody dropped by 50% (Ministry of Justice
[MoJ], 2015) between 2010 – 2013; however, this trend reversed during 2014 when 1,104
women self-harmed in custody, an increase of 6% compared to 2013. Overall, between 2004
and 2014, imprisoned women accounted for 27% of self-harm incidents, but they comprised
only 5% of the total prison population (MoJ, 2015). To date, there has only been a small
amount of research that has focused on the impact on prison staff of working with
imprisoned women who repeatedly self-harm (see e.g., Ward & Bailey, 2011; Kenning et al.,
2010; Short et al., 2009). This study aimed to increase knowledge and awareness of the
effect(s) of repetitive female self-harm on staff working in prisons, on both personal and
professional levels.
Methods
As part of a wider randomised controlled trial that was piloting and evaluating the
introduction of a Psychodynamic Interpersonal Therapy intervention for imprisoned women
who self-harm in three female prisons in England (Walker et al., 2017), which was conducted
from 2012 to 2015, semi structured interviews were conducted with 10 officers, 1 prison
governor and 3 healthcare staff. The interview schedule was informed by previous work in
the field (Ward and Bailey, 2011) and staff were invited to discuss the emotional impact of
working with and witnessing repetitive self-harm incidents by imprisoned women, coping
strategies used, their views on staff support and perceived training needs.
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Participants
Participant recruitment was purposive (Mays and Pope, 1995). Purposive sampling is a form
of non-probability sampling undertaken when strict levels of statistical reliability and validity
are not required because of the exploratory nature of the research (Kidder, 1981). Thirty
prison staff, 10 from each prison, were approached and 14 prison staff were recruited (4
men, 10 women) 7 from one prison, 4 from prison site two and 3 from the last prison. Of
the 14 participants 10 were prison officers, 1 was a prison governor and 3 were healthcare
staff. Table 1 describes the demographic information for the participants in more detail
(pseudonyms are used throughout to protect participants’ confidentiality).
Ethical considerations
Ethical approval for the study was obtained from the Health Research Authority
(12/EE/0179), the National Offender Management Service (NOMS: 76-12), the University
ethics committee where the authors were based and each Prison site. Participants had an
information sheet that contained an assurance of anonymity, information regarding the
study, the possibility to withdraw and the voluntariness of participation. Signed informed
consent was obtained and the findings presented in a way that no one could be recognised.
Insert Table 1 here.
Procedure
The interviews with the prison staff lasted up to 60 minutes and were digitally recorded with
participant’s consent. All interviews were conducted face to face and in a private room
within the prison between January 2014 and January 2015. Before the interview began,
participants read the participant information sheet that presented the aim of the study,
participants then read and signed a consent form. All the prison sites were closed category
for female adults and participants were employed across the three prison sites. Experienced
qualitative interviewers from within the research team undertook interviews.
Data analysis
All interviews were transcribed verbatim and were anonymised to protect the identity of
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research participants and were individually checked for accuracy by a third member of the
research team. Analysis used the systematic method of thematic analysis proposed by Braun
and Clarke (2006). With this analytic strategy, data exploration and theory-construction are
combined and theoretical developments are made in a ‘bottom up’ manner so as to be
anchored to the data (Braun and Clarke 2006). Each transcript was analysed by looking for
patterns in the data and noting themes or analytical categories. This process continued until
no new themes were found – ‘data saturation’. Themes were then clustered together, noting
overlaps and goodness of fit, to form categories, which are reported in the results section of
this paper. Table 2 presents the main overarching themes and subthemes.
Insert Table 2 here.
Rigor
There has been a great deal of unresolved debate about rigor in qualitative research (Grbich
1999). In assessing the quality of the data collected in this study several factors were
considered. Credibility or confidence in the data was gained by the first author’s prolonged
engagement with the data (Guba and Lincoln 1981). Consistency was maintained by keeping
an audit trail and this involved asking a colleague not involved in the study to check over the
author’s decision and analysis processes. Transferability (neutrality) was evaluated by
providing the raw data to a colleague so they could interpret how themes had emerged.
Results
Coping ‘in’ the prison
Many participants stated they had colleagues who portrayed a ‘façade of capability’ and
behaved as if they had been undisturbed by their involvement in a self-harm incident as it
was perceived as “being part of the job” by participants. However, when away from the
prison they were having difficulty coping with the emotional impact of such incidents on
their own psychological well-being.
“Some staff act a bit tough, “I’m alright, I’m alright,” because they don’t want to let
that guard drop, that you’re an officer and you should be going through the flames,
that’s part of your job. But I have known staff to go to the chapel and light a candle
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for somebody but they say, “don’t tell any participant that I’ve done that”. And that’s
putting on the bravado face to other members of staff.” (Brenda, officer)
“Please don’t try and be brave, if it’s affecting you [prison staff], if it’s stopping you
from sleeping, if you can’t get it off your head you need to be letting us [prison
management] know and then we’ll do something to help you. But it’s about getting
staff to accept that… There’s some sort of… unwritten rule is that it doesn’t affect you
[prison staff]. But clearly it, you know, you’d have to be inhuman for it not to affect
you.” (Karen, governor)
Participants used the term “de-sensitization” to describe how they and their colleagues
appeared no longer shocked by self-harm by imprisoned women and not panicking during
their involvement in an acute incident. Becoming desensitized was felt to be inevitable due
to the frequency of exposure to repetitive self-harm incidents, and the range of severities
and methods witnessed.
“What I found was really shocking… was staff’s ability to cope with the levels of
stress, because they would just be probably desensitized is the word, to get through
the day.” (Karen, governor)
Some participants perceived desensitization as having several advantages; in addition, to the
emotional protection of the self (self-preservation) – to prevent the situation escalating, to
support the prisoner, to support other participants, and to promote effective decision-
making.
“I think some of the skills I have learnt is to be very calm in a situation. Don’t “oh my
God, you’ve cut yourself!” “Oh, she’s nearly dead, she’s hanging!” Just deal with it as
a matter of fact incident… Don’t make a big drama out of it…Because especially if
you’re the manager in a struggle situation you have to lead that situation, you have
to be there for everybody… You kind of go into operational mode.” (Joe, officer)
“I’ve been here a lot of years and desensitized…I appreciate that it’s still really quite a
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sensitive thing, you have to support them [imprisoned women] with it [self-harm],
don’t react in such crisis, in such panic about it… I realised that you’re clinically or
professionally not benefitting that person [woman prisoner] if you’re in the same
state of mind as them [women prisoners].” (B, healthcare staff)
Several participants went on to state whether their sense of desensitization to the emotional
effects of witnessing repeated self-harm was storing up psychological damage for the future.
“I don’t know if I’m storing it all up and one day I’ll go pop! I very much doubt it but I
don’t know.” (Sandra, officer)
“If you sat and thought about your experiences in the work situation with the clients
that we have day in day out, that you could become very, very unwell yourself.”
(Trudy, healthcare staff)
Methods used for coping ‘on’ the job
The most common method for coping with incidents of repetitive self-harm on the job
seemed to be informal ‘time out’ during the shift, to go for a cigarette or a brew (cup of tea)
immediately after an incident, before continuing with routine work. This was felt to be
acceptable in terms of acknowledging that the experience was difficult, as opposed to
suggesting that coping with it was difficult.
“I was ordered to go for a cigarette afterwards and I went, “No, no, I’m okay”. “No,
you go for a cigarette please” …You’re a little shaken but then you get on and you
move on and there’s something else to deal with.” (Myra, officer)
“For general on going day-to-day incidents we wouldn’t have that [support]. So you
may have it after. You know, if we’ve had a planned removal [of a prisoner] just to go
“is everybody okay? Let’s have a brew, let’s sit down”, or quite a nasty incident of
self-harm.” (Joe, officer)
“If I’m in charge of an incident… I insist on making sure everybody’s ok and making
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sure everybody has a brew or ten minutes, because your adrenaline s going crazy…
and you just need a bit of down time.” (Bex, officer)
However, the informality of this arrangement was perceived by some participants as a
potential source of conflict as some managers appeared to find it difficult to justify
participants having time away during a shift.
“You can’t just stop the day because that's happened [self-harm incident] … you
might deal with that one incident, you then can’t sit back, take some time, reflect,
support… if a member of staff said to me “I’ve just had a horrendous afternoon… I’m
going to disappear for an hour because I need to clear my head”, I’d have to make
a ... as a manager, you know, obviously care of this person [prison staff], welfare but
at the same time... It’s an operational job, you've [prison staff] got a job to do and
you need to do it.” (Joe, officer)
“That is difficult to manage, that work life balance, but what you find happens is
people [prison staff] think it becomes their right… you’ve got to say no because it’s
got to meet the business need as well, hasn’t it? So it’s about what’s right for them
[prison staff] but what’s right for the business as well.” (Karen, governor)
Some participants appeared resentful at what they perceived as management’s inability to
understand their needs.
“As much as the governors and so on can be supportive they have perhaps never
experienced anything that we experience on the ground floor because they’re so
distant from it... they’ll be supportive one day and trying to get you back into work
the next, and that's the situation. They [managers] don't understand, I don't think, all
the in-depths of what really goes on.” (Myra, officer)
“What good is it the governors knowing all about the ins and outs of everything when
people who are dealing with it day in, day out need to know? They need to be the
experts and the participant need supporting.” (Trudy, healthcare staff)
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Most participants dismissed the formal support mechanisms or attempted to avoid being
seen to accept support from the Care Team in the prison, who are prison staff that offer
confidential peer support to colleagues following a traumatic incident (NOMS, 2010). No
explicit reason was given for this, although there are many references to participants being
expected to be involved in challenging incidents as part of their role.
“I’ve dealt with a lot of people via the Care Team but generally I know the staff and
will say “I don't want the care team. I’m okay”.” (Myra, officer)
“I personally wouldn’t use them [the Care Team]. I would make a beeline for my
friends in the service and people I trust… I probably wouldn’t necessarily make a
beeline for the Care Team, but they do offer the help.” (Bex, officer)
“We’ve also got our local participant Care and Welfare Team, which is fabulous, but
again, I don’t think people [prison staff] use it much, because there’s an element of,
not bravado but… “this is our job, this is what we do. If you’re coming to a prison
you’re probably going to see people who fight, take drugs, self-harm, shout at you,
swear at you, threaten you with violence” … So, there’s an element of that “get over
it”.” (Joe, officer)
Coping ‘away’ from the prison
It seemed that being away from the prison, allowed many participants to feel abler to
process their reactions to difficult experiences, such as witnessing repeated self-harm; and
were therefore more willing to accept help and support once they had left the prison
environment. Participants were more open to accepting support from the Care Team and
their colleagues by telephone at home, for example, rather than seeing a member of the
Care Team in the prison. This was because some participants continued to experience stress,
troubling thoughts or difficulty coping with a self-harm incident once they had left work.
Also, some participants related this to the desire to hide what they may perceive other
prison staff may see as being a failure to cope with the challenges they are expected to deal
with in the job.
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“I was given a brief as soon as I entered the prison by the duty governor, who had
come in, and then a brief about the participant who found the body and so on and
then, yeah, support, and they all started, “no, I’m fine,” but I spent at least two
weeks being in contact with nearly all the staff afterwards [away from the prison].”
(Myra, officer)
“They [prison staff] used to phone me up at home in floods of tears because they
kept hearing a prisoner chewing through her skin, and that’s all they could hear.”
(Karen, governor)
Meeting with colleagues away from the prison was also a preferable means of obtaining
peer support.
“All of the staff on the unit… we all met in the pub and a few of us went who were in
uniform and we rang up the people [prison staff] that weren’t in work and they all
came from home and we all sat round and we were all literally kind of “what’s going
to happen now?” And it’s having the support of those people [prison staff] who all
came in from home.” (Sandra, officer)
“I can kind of go away and talk about it [self-harm] with someone… We support each
other quite well, me and [name] bounce off each other and can sort of talk it through
if something’s bothering us. But yeah, I don’t think I need any extra support.” (Ann,
officer)
Once at home, participants identified several stress management strategies that were
unrelated to the prison or their colleagues, including seeing friends and exercising. The
ability to avoid thinking about work whilst at home was also important to many participants.
“You hear about people “oh, I’ll go home, I have to have a bottle of wine because I’ve
had a stressful…” I don’t drink to excess. I’ll drink when I go out. Play some sport, play
rounder’s and stuff like that, and I’ve got quite a good friendship network that go out
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a lot, go on holidays.” (Sandra, officer)
“I do have a treadmill and I’ve got my own gym, so I guess if I was to drive home
angry [after work] I’d probably spend a bit of time and take it out on a work out.”
(Phil, officer)
“It’s about putting your radio and your keys away before you go home, turn the
music on in the car and just let it ride.” (Ann, officer)
Future training to cope ‘with’ the job
Participants consistently asserted that they had little to no formal training specifically related
to supporting women who self-harm in prison, apart from the generic ACCT training. Many
participants appeared to feel this was inadequate, given that dealing with imprisoned
women who self-harm is a key aspect of their role. They also spoke about being unprepared
for the levels of mental illness seen in imprisoned women.
“A lot of senior officers who are managers of the ACCTs on wings, absolutely no idea,
and they’re the ones that are managing the risk of the self-harm and they don’t know
anything about [self-harm].” (B, healthcare staff)
“I’m a prison officer… So why am I dealing with people with acute mental illnesses
when we’ve got mental health hospitals?... And the way we can deal with people
[imprisoned women] is so limited… we just lock people [imprisoned women] up, we
put them in a room. Compared to a hospital or mental health unit it’s a lot different,
the facilities there… Either give us [the prison and prison staff] those facilities if
you’re going to send us [the prison and prison staff] those people [imprisoned
women with mental health issues] or don’t send us those people [imprisoned women
with mental health issues] in the first place.” (Joe, officer)
Several participants called for formal training and supervision in relation to self-harming
behaviour but highlighted that there were institutional barriers were a main reason why
training was not accessed and these would need to be overcome.
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“I think more awareness around what self-harm is, why people self-harm, how we
[prison staff] can manage it, ways of coping and ways to help participant… How staff
can offload if they need to if they’re feeling frustrated or it’s [witnessing self-harm]
upset them.” (Ann, officer)
“I think [staff] need supervision, which I’ve been told they don’t get. I think even just
the kind of awareness phase of it, because a lot of them {prison staff] inevitably have
a negative stance with regards to personality disorder because all they see is the
negative side of it, the self-harming, the manipulation.” (Peter, healthcare staff)
“So, we [the prison] haven’t really invested enough where everybody who comes
into this prison who’s going to have contact with residents, mandatory, has to have
introduction to safer custody. We don’t do that. It takes four hours… But everybody
seemed to get keys, everybody managed to get the key talk, but when we said to
them you’ve got to come for a four-hour session, we just don’t seem to be able to get
people there [into training].” (Joe, officer)
Discussion
Fourteen prison staff were interviewed about their experiences of working with imprisoned
women who repeatedly harm themselves. Staff gave accounts that illustrated that they
believed they should not have difficulty coping with challenging incidents such as self-harm
or aggressive behaviour by imprisoned women. Staff described that this should be expected
in a prison environment (Moses, 2013). Consequently, it appeared that staff were reluctant
to ask for, or openly receive formal support from the prison. Staff reported using other
coping strategies in and away from the prison to manage the stress they encountered
because of working in this area. Coping ‘in’ the prison meant that staff had to maintain a
‘façade’ of being untroubled by having witnessed repeated self-harm incidents; even though
they admitted finding this difficult at times. Some staff felt desensitised to the emotional
impact of seeing the imprisoned women’s self-harm due to the high frequency of this
occurrence. However, they worried that this could indicate future psychological difficulties
(Wright et al., 2006). Methods used for coping ‘on’ the job following a challenging situation,
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included staff commonly needing a ‘time-out’ for a drink or cigarette to regroup. This could
cause conflict, as some managers were reluctant to allow this because of the potential
disruption to prison operations. Moreover, staff frequently refused the formal options for
support that the managers offered, such as referral to the Care Team. It is possible that this
is due to prison staff being expected to deal with challenging incidents on a day-to-day basis
(Moses, 2013), and thus suggesting that accepting support implies that they are unsuitable
for the job.
Coping ‘away’ from the prison, many staff accepted the Care Team’s support by
telephone; or met with their colleagues in informal settings such as the pub. Socialising with
friends who were not colleagues, exercising, drinking alcohol and going on holidays were
also identified as coping strategies. Staff largely felt that being unable to ‘switch off’ from the
job once away from the prison was a sign of poor coping. When discussing future training to
cope ‘with’ the job staff indicated that ‘training’ was an important factor. All the staff in this
study reported that they had received no formal training to support imprisoned women who
self-harm, though some were trained to complete the ACCT process. Some staff voiced that
they felt inadequately prepared to cope with the increasing numbers of imprisoned women
presenting with mental health problems. Staff identified institutional issues such as poor
staffing levels and the prioritisation of other training, for example in security, as barriers to
accessing training on self-harm and mental health issues.
There are issues regarding the transferability/generalizability of these findings to
other women’s prisons. This is because this study was conducted in a closed category prison
for female adults, with a predominately female staff sample. Interviewing more male
participants and/or staff dealing with other imprisoned women in different prison settings
may have resulted in a different picture of staff’s responses to repeated self-harm. However,
the themes presented here are supported by evidence from the data itself (Braun and
Clarke, 2006; Gust, MacQueen and Namey, 2012). The techniques of thematic analysis
(Braun and Clarke, 2006) enabled the unique perceptions of individual participants to be
recognised, which could have been rejected as anomalous using other methods (Bird, 1998;
Braun and Clarke, 2006; Flick, 2009). Additionally, purposive sampling was used to ensure
that a range of professional roles within the prisons was represented (Kenning et al., 2010;
Guest, Namey and MacQueen, 2012).
Conclusion
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From these interviews, it appears that prison staff feel inhibited from accessing psychological
or emotional support from their employers (Justice Committee, 2009; Moses, 2013).
Exploring whether this is a common experience, and whether uptake rates differ across
different prisons, could indicate whether the issue requires addressing at a broader
organizational level. A subsequent investigation into why staff seem to hold negative
attitudes towards formal support and why they do not access the training that is often made
available could be useful in determining how to make it more acceptable, and useful to staff.
Ultimately this could help make support more accessible to prison staff, promote their
health and wellbeing, help improve the morale and satisfaction of prison staff and reduce
work related stress (Towl and Forbes, 2002; Mackay et al., 2004; Short et al., 2009; Kenning
et al., 2010; Marzano, Adler and Ciclitira, 2013; Moses, 2013). Lastly, for staff to be able to
manage their own psychological and emotional wellbeing in response to supporting
imprisoned women who self-harm, it seems that a culture shift is required to permit staff to
admit their needs, and to seek support (Justice Committee, 2009; Kotter, 2012; Moses,
2013). This could be implemented through supervision and by senior staff leading by
example (Kotter, 2012).
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Table 1: Descriptive characteristics of participants
Name Grade Gender Length of service in the prison service
Myra Officer Female 8 years
Bex Officer Female 8 years
Ann Officer Female 11 years
Joe Officer Male 23 years
Sandra Officer female 12 years
Frank Officer Male 10 years
Pam Officer female 5½ years
Phil Officer male 23 years
Mira Officer female 18½ years
Brenda Officer female 26 years
Karen Governor Female 28 years
Peter Healthcare Male 1 year
Trudy Healthcare Female 15 years
B Healthcare Female 7½ years
Table 2: Main themes and subthemes in the analysis
Overarching themes Subthemes
Coping ‘in’ the prison Façade of capability
Being part of the job
De-sensitization
Methods used for coping ‘on’ the job Informal time out – ‘brew time’
Conflict and resentment at management
Dismissing or avoiding formal support mechanisms
Coping ‘away’ from the prison Processing reactions to difficult experiences
Peer support away from the prison
Future training to cope ‘with’ the job No formal training for women who self-harm
Unprepared for the levels of mental health
problems
23