Self-harm in a men's prison: staff's and prisoners' perspectives.

This thesis draws on feminist and critical phenomenological perspectives to explore the issue of self-harm in men's prisons. In relation to what remains a "hidden problem" (Howard League, 1999, p. 1), the needs of men harming themselves with no apparent suicidal intent have been particularly overlooked, as have those of staff dealing with this
complex behaviour. In-depth interviews with 20 adult male prisoners and 38 members of staff explored participants' experiences, views and concerns in relation to repetitive, non-suicidal self-harm. A pluralistic methodological approach, drawing on the principles of thematic and discourse analysis, informed the analysis of interview data, to reveal dominant themes, as well as tensions, inconsistencies and possibilities for change. As shown by previous studies, the notion of non-suicidal self-harm as "attention seeking" was a recurrent theme amongst staff, especially officers, doctors and nurses. This was situated within multiple, and at times overlapping, discourses, including 'medication seeking', 'poor coping' and 'cry for help' themes. In many accounts, less stigmatising discourses also existed, but were applied to specific types of 'self-harmers' (often a minority) in a rigid and hierarchical manner. Interviews with specialists and prisoners challenged this "stereotypical view", re-positioning men who self-harm as 'victims' and/or 'survivors' of their "imported vulnerability" (Liebling, 1995), and of the "pains of imprisonment" (Sykes, 1958). Amongst the latter, difficult relations with staff, and negative reactions to self-harm, were reported to have important implications for prisoners and their self-harming behaviours. Locating these responses within the context of staffs roles and occupational cultures helped to further understand and deconstruct the sorts of reactions that prisoners identified as "dangerous" and dehumanising, and
also brought attention to their possible functions and effects for staff themselves. The wider context of work also provided a useful focus to consider how negative staff reactions to self-harm may be addressed. Eliciting staffs views and preferences for training, support and supervision revealed some of the tensions in supporting staff – and prisoners - in an under-resourced and over-crowded environment, and where a 'macho' form of managerialism, and actuarial conceptualisations of 'care', arguably hinder the welfare of both prisoners and staff. The thesis concludes by reflecting on these findings, the ways in which they were produced, and their wider implications for future policy and research.

A thesis submitted to Middlesex University in partial fulfilmentfor the degree of Doctor of Phüosophy.