Ireland: prison service and HSE seek to put new supports in place to reduce self-harm in prisons

A new tender request jointly issued by the HSE National Office for Suicide Prevention and the Irish Prison Service said they want to “gain greater insight into the effectiveness of current practices being used in the prison service to manage self-harm and suicidality” and “obtain research and implementation support to assist with the roll-out of an evidence-based intervention (CAMS) to manage presentations of self-harm and suicidality in the prison population”.

“The prison population is an extremely vulnerable one and is more likely to exhibit characteristics associated with self-harm than the general population,” it said.

“Self-harm in prison is not only a risk factor for prison suicide, it can be a major problem for the prison and impact on (staff and inmate) morale within the institution.

“In addition, risk factors for self-harm among those in custody will be different to those of the general population.”

“An essential component of suicide prevention in prisons is having a surveillance system in place to monitor the incidence of self-harm and suicide attempts. Such a system will provide robust information relating to the incidence and profile of self-harm within prison settings, identify individual- and context-specific risk factors relating to self-harm and examine patterns of repeat self-harm (both non-fatal and fatal). Such information can be used to inform the identification and management of those in custody engaging in — and at risk of — self-harm, and to develop effective prevention initiatives.”

Since 2016, the SADA (self-harm assessment and data analysis) project has been working in the prison system and has published two reports, the most recent for 2018.

That report found that there were 263 episodes of self-harm recorded in Irish prisons in 2018, involving 147 individuals — an 18% increase on the number of episodes recorded in the 2017 report. While the majority of prisoners who self-harmed were male, the rate of self-harming behaviour was a staggering 5.7 times higher for female prisoners. Self-harming was also higher among prisoners on remand than those who had been sentenced.

The IPS said it is planning to implement an evidence-based intervention, Collaborative Assessment and Management of Suicidality (CAMS), to support frontline IPS staff in responding to self-harm behaviours and suicidality in the prison population.

“The CAMS intervention prioritises the suicidal service users’ point of view in collaboratively identifying the drivers of their suicidal thoughts and feelings, and planning treatment accordingly,” the tender said.