Article2011

A National Survey of Self-Injurious Behavior in American Prisons

Kenneth L. Appelbaum · Judith A. Savageau · Robert L. Trestman · Jeffrey L. Metzner · Jacques Baillargeon

60 citations0/0 files storedPsychiatric Services

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Suicide and Self-Harm Studies Criminal Justice and Corrections Analysis Psychopathy, Forensic Psychiatry, Sexual Offending

Abstract

OBJECTIVE: This study sought information about the prevalence, epidemiology, and management of self-injurious behavior by inmates in U.S. prison systems. Although self-injurious behavior has long been the source of significant challenges in correctional settings, limited research is available on this topic. METHODS: Mental health directors in all 51 state and federal prison systems were invited to respond to a 30-item questionnaire available online or in hard copy. Univariate statistics were used to describe significant aspects of the national experience with self-injurious behavior, and bivariate statistics were used to examine relationships between variables. RESULTS: Thirty-nine systems (77%) responded to the survey. Responses indicated that <2% of inmates per year engage in self-injurious behavior, but such events were reported to occur at least weekly in 85% of systems, with occurrences more than once daily in some systems, thus causing substantial disruptions to operations and draining resources. The highest rates of occurrence of these behaviors were in maximum-security and lockdown units and most often involved inmates with axis II disorders. Despite the seriousness of the problem, systems typically collect few, if any, data on self-injurious behaviors, and management approaches to dealing with them lack consistency within and across systems. Eighty-four percent of respondents expressed interest in participating in further studies on this topic. CONCLUSIONS: The survey responses indicated the disruptive effects of self-injurious behavior in the nation's prisons, a need for better epidemiologic monitoring and data on such behavior, and the importance of developing and widely using effective interventions. The high response rate and expressed interest in follow-up projects suggest that state and federal correctional mental health directors see a need for better information and management in this area.

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2021The Journal of the American Academy of Psychiatry and the Law.2007Mail and Internet Surveys: The Tailored Design Method 2007Mail and internet surveys: The tailored design method, 2nd ed.1999Mail and internet surveys 1998Self-mutilation in clinical and general population samples: Prevalence, correlates, and functions.2003Deliberate Self-Harm in a Nonclinical Population: Prevalence and Psychological Correlates 2008Identifying clinically distinct subgroups of self-injurers among young adults: A latent class analysis.2006Suicide Attempt Self-Injury Interview (SASII): Development, reliability, and validity of a scale to assess suicide attempts and intentional self-injury.

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