A Social Survey Examining Self-Harm in Prisons - Essay Example

Research Proposal: A Social Survey Examining Self-Harm in Prisons BY YOU RELEVANT SCHOOL INFO HERE HERE 0 Objectives of the research Deliberate self-harm occurring with prison inmates is a significant problem in the United Kingdom and abroad. Deliberate self-harm is defined as “any act by which an individual intends to harm the self physically” (Isacsson and Rich 2001, p.213). Common self-harm methods include purposefully ingesting poisonous substances, overdoes of controlled substances, stabbing oneself utilising a variety of weapons or sharpened objects, wounding the self in the abdominal region or upon the arms, or even significant self-mutilation that can produce various lesions or require hospitalisation for its severity. There are various rationales for why a prison inmate harms the self, ranging from psychological disturbances to even attempts to manipulate the prison officers to elicit change to their incarceration circumstances. Self-harm is a phenomenon that occurs with both male and female prisoners, thus it is not a gender-specific problem within the prison system. Statistics indicate that female prisoners, in 2003, represented only six percent of the total prisoners incarcerated in the entire UK prison system, but female self-harm constituted 46 percent of all national reports of self-harm in the country (Borrill, Snow, Medlicott, Teers and Paton 2005). Self-harm in prisons is costly to the prison system, taxpayers, and the health care system for those that require psychological counselling and, oftentimes, recurring medical treatment for this activity. The severity of the problem justifies conducting a research study to analyse the catalysts of self-harm, especially with female inmates that represent nearly half of all national reports of self-harm. Prison officers and medical practitioners have multitudes of responsibility for ensuring prisoner safety, ensuring the integrity of the prison system, and providing health care services to a broader population. Self-harm recurrences and its prevalence in the UK add significant burdens to the health care system and for prison officers that must develop documentation of these events and provide supplementary mental health services to recognised problem prisoners. This research study maintains three distinct objectives in an effort to analyse self-harm in the prison system. Identify the most common psychological causes of what drives prisoners to conduct self-harm and self-mutilation. Identify the most prevalent sociological catalysts of self-harm occurrences, including, but not limited to, the prison social systems or relationships with prison officers. Examine socio-historical instances of negative lifestyle scenarios that might exist in female prisoners, including, but not limited to, previous childhood or spousal abuse, mental health conditions, or stunted cognitive/developmental growth during various phases of child and adolescent development. The broader purpose of the study is to identify and categorise, statistically, the most frequent and common catalysts of what drives self-harm with female prisoners. By identifying the psychological, sociological or historical lifestyle drivers that cause self-harm, it will assist the prison system officials, the Ministry of Justice, and various clinical and mental health practitioners in developing a model of treatment to facilitate more effective prison adjustment. The results of the research are intended to improve psychological testing instruments that are utilised with contemporary prisoners to create more accurate profiles of prisoners to assist in treatment methodologies to prevent recurrence with certain individual prisoners in the prison population today. 1.1 Literature review Suicide is a common outcome of prison life, especially prevalent with individuals that have been sentenced to life imprisonment. Approximately one-half of prisoners that have committed suicide whilst incarcerated have been involved with reports of self-harm (Foster, Gillespie and McClelland 1997; Ovenstone and Kreitman 1974). Prisoners that commit suicide whilst incarcerated cast doubt on the managerial and structural competencies of prisons from a social responsibility standpoint. Additionally, stakeholders in society that seek justice for criminal behaviour are shorted when prisoners escape their long-term confinement by taking their own lives. The implications of suicide in the prison system are broad and impact many in society. Because such a wide margin of prisoners have been reported for at least one historical instance of self-harm, it serves as a potential predictor of future suicidal intentions that could be better addressed if the catalysts for what drives self-harm are identified concretely. There is another research-supported viewpoint that it is the tangible relationships between inmates and the prison officers that contribute to self-harm intentions and practice. Dooley (1994) provides the argument that it is the prison culture and environment that should become the focus of researchers as a predictor of self-harm behaviours. Correctional officers in the prison system are responsible for setting the tone and cultural dynamics of the prison system and, therefore, can be directly responsible for inmate reactions to the cultural systems that drive sociological conditions. Liebling (1992) supports this notion, offering that prison officers are directly responsible for identifying the motivators and cultural conditions that might contribute to self-harm intentions and should be more integral in discussing prisoner concerns and problems. Liebling further provides accountability for correctional officers in being a referral entity for special psychiatric treatment for prisoners after consultation and observation of the internal prison culture and through discussion with prisoner needs. All prisons are operated differently and maintain unique prisoners with various psycho-social needs, values and beliefs. In similar accord, all prisons maintain correctional officers with these same, diverse moral, ethical and cultural values. The implications that it could be correctional officer involvement in prisoner interventions and prison culture development as catalysts is a rather contemporary viewpoint when attempting to assess self-harm activities and intentions. This is why the role of correctional officers and their sociological and professional relationships with prisoners requires examination. Pannell, Howells and Day (2003) take the aforementioned situation further, performing a research study utilising a sample of correctional officers in the existing prison system to determine their own thoughts on what officers believed served as catalysts for self-harm intentions. The most prevalent personal beliefs included: Drug effects Inherent depression in the prisoner An ability to cope effectively from a psychological perspective Stress caused by entry into the prison system Historical family problems and turmoil Bullying occurring from other prisoners All of the aforementioned officer-generated responses about the drivers and motivations of self-harm indicate that it could be a blend of psychological, sociological and internal cultural problems at the prison that contribute as predictors of self-harm behaviours. The belief that stress from prison entry and bullying occurrences would seem to point toward internal prison culture that serve as contributors, as well as a variety of psycho-social considerations. The research of Pannell et al. (2003) reinforces the need to examine prison culture as a potential vehicle by which self-harm occurs. Other researchers disagree with externalised contributors to prisoner self-harm, believing that the majority of intentions to conduct these behaviours are inherent to the inmate. Recognised and documented catalysts for self-harm, from a mental health perspective, include depression (Hawton et al. 1999), bipolar disorder, phobias (Hawton et al.), and even inborn anti-social behaviours (Wessely, Akhurst, Brown and Moss 1996). The complexity of research-supported psychological problems as potential contributors to self-harm justifies this research into the mental health conditions of female prisoners. As most prisons are equipped with mental health counsellors or referral systems for more intensive therapeutic interventions, this research maintains the potential opportunity to provide prison officers and supplementary service providers with a framework by which to recognise symptoms associated with psychological maladjustment that could motivate self-harm intentions. Outside of the more obvious catalysts for self-harm, such as drug abuse, the psychological considerations are not as easy to identify, but require intensive investigation to determine their influence on the behaviours. All of the aforesaid potential catalysts for self-harming activities illustrate the necessity to examine sociological, psychological, and prison officer relationships in this social research effort. Coppen and Farmer (1998) report evidence that illustrates the drug lithium has been highly effective in reducing self-harm behaviours for those that have bipolar disorder. Furthermore, a clinical trial using the antidepressant drug paroxetine, in conjunction with the use of a placebo with the sample recruited for the study, illustrated that antidepressants can be a useful method for reducing further instances of self-harm (Verkes, Van Der Mast, Hengeveld, Tuyl, et al. 1998). It is important, therefore, to recognise the specific mental health disorders that exist within the prison environment in order to prescribe the appropriate treatment options that are known to prevent self-harm. This research study maintains the opportunity to assist in understanding whether mental health disorders exist with an identified sample of prisoners by collecting various demographic and socio-historical considerations and correlating them to self-harm intentions and motivations identified through the research process. 2.0 Access to respondents Negotiating entry related to the study will involve preliminary letters to the leadership (wardens) of the prison system requesting permissions to conduct a research study within the prison environment. The letter will include the purpose and scope of the study, including an addendum that reinforces the motivations for the study, the objectives and ultimate goal of reducing self-harm with inmates. It will be crucial for gaining access that the prison leadership understand fully the intention of the study and avoid any concerns that might arise about why the study is being undertaken (Marshall and Rossman 1995). This is critical as it is recognised that many prison officials often maintain negative sentiment about researchers entering the prison system and guards often illustrating hostility toward the research process. Furthermore, there could be concerns with the gatekeepers of the prison system about the legitimacy of the researcher to perform the social research study (Spencer 1982). A letter illustrating the educational background and knowledge in social sciences will accompany the preliminary writings in an effort to satisfy any potential apprehension about allowing access to this often high-risk population of inmates. Researchers have a great deal of consensus that trust and identity are vital in gaining access to desired participants (Lee 1993). Winkler (1987) suggests that there should be some variety of face-to-face interaction in the negotiation process, even though it demands time and legitimised effort on behalf of the researcher. After delivering the preliminary letters stating the purpose, intention and researcher capabilities, contact will be made with appropriate prison leadership via telephone to reinforce a desire to gain access to prisoners. Upon gaining access for negotiation to conduct the research study, the researcher will come to the meeting prepared with historical research study synopses and outcomes of previous prison-related research. The researcher will prepare a portfolio of findings, duration of previous studies, and a variety of methodological approaches that justify the necessity of conducting a social research study. Via telephone and face-to-face negotiations, the researcher will invite the prison leadership to recruit any variety of prison guard officials or other relevant service providers to attend the meeting. The development of a portfolio of historical research results, coupled with a friendly and non-aggressive discussion with appropriate representatives of the business is to familiarise the gatekeepers with researcher prowess and competency and build trust in the researcher’s ability to conduct research responsibly and illustrate a willingness to accept potential risks to personal security when working with deviant or other high-risk inmates. The UK prison system maintains many systems and bureaucracies that serve to complicate sample selection. Oftentimes, because of these hindrances, the researcher will be forced to work with samples that have been approved by the gatekeepers and leadership of the prison (Adams 2010). The researcher will identify the variety of potential participants that would provide the most value to the research project, allowing opportunities for the prison representatives to describe the policies and procedures in the prison system that could assist or hinder the research process and sample selection. By allowing for open discussion and reciprocal negotiations, an important method of gaining access (Rossman and Rallis 1998), it should assist in negotiating access to desired participants and further building trust in researcher integrity. The researcher, by following the aforementioned method of negotiating access, should be able to overcome certain bureaucratic barriers to this special group in society. It will illustrate to the leadership of the prison that the researcher understands the limitations associated with prison policies and is willing to work reciprocally in a method that will benefit both the researcher and the prison gatekeepers. The researcher will negotiate access to various mental health practitioners involved with providing counselling or other therapeutic services to prisoners in order to utilise pre-existing report findings about demographics, diagnoses, or professional expert assessments (qualitative) about various prisoner conditions. By allowing the leadership of the prison to offer these suggestions as to which mental health practitioners maintain the most competency or can circumvent various in-house rules and restrictions, it will again reinforce that the researcher is willing to work cooperatively and respect the authoritarian regimes that guide prison operations. Again, the end result of negotiating in this fashion is to build important trust between researcher and the most vital gatekeepers responsible for providing access and security. Taylor and Bogdan (1984) suggest that the researcher should be truthful, but maintain some level of vagueness about objectives in order to remove gatekeeper concerns about ethical issues. There are certain mental health conditions that are regulated, through legislation, to maintain confidentiality. When negotiating access with the mental health practitioners involved in providing prison mental health services, the researcher will present a confidentiality agreement that guarantees no prisoner names or other identifiable demographic information will be included in the study upon publication. The researcher will allow all important stakeholders involved in this research project to make appropriate copies of these agreements, or modify them where appropriate to prison regulations and processes of confidentiality, to ensure that liabilities are passed onto the researcher. This will remove perceptions of liability for the prison representatives, securing more trust in researcher competency to recognise the rights of prisoners and the legal accountability for the prison system. 3.0 Drawing a Sample Because the literature review indicated a potential blend of psychological and sociological catalysts for self-harm, it will be important to identify a sample that maintain documented mental health illnesses or have known historical problems stemming from socio-historical lifestyles. This will require assistance from mental health practitioners and the prison leadership to identify an appropriate sample that also satisfies prison regulatory processes. The researcher will inquire to receive access to prisoners that have been documented as conducting self-harm through a search of the penitentiary software database or other relevant tangible files on this phenomenon. HMP Styal and HMP Buckley Hall in Northwest Britain are the relevant prisons that house large volumes of female prisoners that have been sentenced for their crimes. Purposive sampling will be the methodology of choice in selecting an appropriate sample. Under this sampling method, the researcher utilises their own judgments regarding which participants would provide the most value regarding this social research effort and then attempt to invite these identified individuals to participate in the study (Marshall 1996). As it has been identified that many prisoners that attempt self-harm maintain a variety of mental health conditions, ranging from bipolar disorder to anxiety disorders, consultation with mental health practitioners and records management personnel will be required for purposive sampling. Individuals that are identified through records assessments that maintain cognitive dysfunction (i.e. language barriers or comprehension issues) will be eliminated as potential participants to the study. For issues of validity, the researcher will request a random sample to serve as a control group. This will represent a moderate sample of prisoners that are incarcerated and do not maintain historical reporting of self-harm behaviours. As criminal records are public domain, the researcher anticipates no problems in utilising a standard protocol framework to identify important characteristics of the control sample. This includes gaining access to penitentiary records illustrating age, socio-historical backgrounds, and records that indicate maltreatment during childhood (when applicable), following the methodological approach of Mohino Justes et al. (2004). Examination into penal records and variety (if any) of disciplinary instances will be performed to identify those who appear high-risk and correlated with instances of known self-harm. The penal records and demographic records will enhance correlative analysis as well as identifying an appropriate sample to determine whether socio-historical and criminal behaviours predict self-harm instances. As the literature on the subject of self-harm does not indicate any reputable hypotheses regarding self-harm and its relationship (prevalency) to deliberate self-harm behaviours, theoretical sampling methods were rejected as a viable recruitment strategy. Under purposive sampling, additional records maintained by the penitentiary’s computerised records of emergency care for self-harm instances will be evaluated to identify an appropriate sampling of relevant participants for the study. There is very little evidence that random sampling would be appropriate, as this methodology assumes that participants would maintain normally distributed properties. The complexity of relationships associated with prison culture, officers and inmates and the diversity of identified mental conditions does not justify utilising random sampling as a viable methodology. There must be congruency with socio-historical characteristics, penal records and disciplinary actions, and known mental health problems to fully explore the correlative properties of behaviours in self-harm and psycho-social tendencies of desired samples. A secondary sample involving current prison officers working with inmates on a daily basis will be recruited to gain important information about their perceptions of prison culture and their relationships with inmates. An appropriate sample to identify potential correlations or discrepancies in self-perceptions of culture should consist of ten to 15 prison guards or prison leaders. The researcher will ask for assistance from the leadership of the prison on identifying relevant and accessible guards to participate in the social survey. The intention is to measure the potential correlative relationship between culture and officials/inmate relationships. 4.0 Distributing a social survey The survey will be delivered to the recruited samples face-to-face. This will allow the researcher to ensure that the surveys are completed properly, thus avoiding the general abandonment of partially-completed or illegible surveys that often accompanies survey research when utilising postal services or other self-completion activities. Face-to-face researcher facilitation of the survey can assist in answering questions (oftentimes prison inmates lack higher order educational and reading skills), to ensure a higher ratio of properly returned surveys. For cost purposes often associated with postal delivery, including laborious efforts by the researcher to follow-up on whether internal representatives of the prison are following the appropriate distribution instructions, face-to-face facilitation is most cost-effective and appropriate. Finch (1984) identifies that when performing research and consulting with females, a feminist philosophy should be adopted. It should be a cosy, comfortable, and empathetic experience when participating in a research study (Finch). Facilitating the completion of surveys using the aforementioned concepts of feminism should facilitate more willingness to complete the survey effectively through the provision of trust-building occurring when working with female participants. Trust is not only important in negotiation for access, but when evaluating and approaching participants. Depending on the volume of participants identified through purposive sampling methodology and evaluation of prison record systems, the desired sample should include between 50 and 75 inmates that fit the purported participant criteria identified. The British Criminology Code of Ethics for researchers indicates that the researcher has a duty to ensure that the participants are not adversely affected physically, socially, or psychologically by participation in the research study. Utilising empathetic and non-biased approaches to facilitation of the survey research will ensure that all ethical codes are abided by, working diligently not to sway the responses and introduce bias in any fashion or cause harm to the participant. 5.0 The questionnaire The presence of mental health disorders and symptomatology will be measured utilising a preliminary supplement: The Million Clinical Multiaxial Inventory II Questionnaire. This measurement instrument consists of 175 true/false questions designed to identify personality disorders. Such disorders include schizoid, depressive, narcissistic, antisocial, compulsive, and even masochistic tendencies. It is a respected psychological model that will be distributed along with the survey to determine the prevalence of existing personality disorders or tendency to manifest these disorders (See Appendix A for sample of the MCMI II Inventory). The results will be compared to known clinical diagnoses identified through the assessment protocols described in Section 3.0 of this proposal to identify correlations with the standard scoring procedures provided by the MCMI II. A simple questionnaire will be delivered to the prison officers identified in the sample, consisting of 20 questions related to the prison culture. Questions will include such terminology as cohesive, scattered, hostile, or unified, inquiring for the sample of prison representatives to describe cultural dimensions perceived in the organisation. An opportunity for a 100 word analysis of perceived cultural aspects will be provided to create more depth to the study and evaluate differences or similarities in officer sentiment. Relationship-related questions about inmates will include such terminology as cohesive, regular, intimate, or distanced to determine the level of interaction and closeness established between officers and inmates. For the inmate participants, a questionnaire will be developed with ranked criteria, in order to determine the extent to which the participant feels that self-harm has been caused by certain environmental, psychological or sociological considerations (See Appendices B for a sample of this questionnaire design). Simple ranking will facilitate easier coding of the findings and also identify median scores or correlations that might exist to illustrate a connection between various criteria and self-harm intentions. There is a phenomenon in human behaviour known as self-referencing effect, stating that participants can more easily identify self-referent adjectives than attempting to rank characteristics or adjectives describing others (Kuiper and Rogers 1979). Allowing the participants to refer to themselves, rather than attempting to offer their (likely biased) assessment of relationships with officers, serves as the underpinning rationale for this ranked approach. 6.0 Coding Data from the questionnaires will be analysed utilising the Statistical Package for the Social Sciences (SPSS). Coding will involve utilisation of the Chi Square and Mann Whitney U-Test. Under the Mann Whitney U-Test, all observations from the questionnaires are given ranking into a singular series, a non-parametric testing method of a determined null hypothesis that a sample can be tested against a control sample to determine probability. The Chi Square process will determine the cumulative distribution identifying covariance or correlation with key criteria. It is proposed that the level of significance will be p < 0.05. Findings will be disseminated to the leadership of the prison system as a reciprocal reward for their access and participation of the study. Findings will be distributed to participants if the prison processes and regulations allow for this public presentation with a letter thanking the chosen participants for their valuable participation in the study. If significant correlations are discovered between observed mental health conditions identified through the MCMI II Inventory and self-harm rankings, these will be charted in easy-to-follow formats to illustrate the largest predictors of self-harm behaviours. If there are no significant correlations discovered between sociological or psychological considerations proposed to be predictors of self-harm behaviours, these discrepancies will be produced in the form of a discussion section describing the limited findings. As the goal of the study is to facilitate more effective treatment methods and identification of self-harm predictors, if findings do not identify correlative results, these must be identified for future researchers studying this behavioural phenomenon. Thus, insignificant findings would require publication in relevant journals to assist in creating a more focused study to avoid replication of these results. If correlative findings are significant, the findings can be publicised in academic journals to illustrate a potential hypothesis of certain self-harm behaviours and their relationship to environment or inherent psycho-social characteristics. Whatever the findings produce, the results will be distributed to the British Society of Criminology where results can be networked with appropriate entities involved in criminal justice including the Ministry of Justice and other appropriate mental health practitioners charged with providing health services to the UK prison system. References Adams, L.S. (2010). Sampling ‘hard to reach’ populations in qualitative research: the case of incarcerated youth, Qualitative Social Work, 9, pp.536-550. Borrill, J., Snow, L., Medlicott, D., Teers, R. and Paton, J. (2005). Learning from ‘near misses’: interviews with women who survived an incident of severe self-harm in the prison, The Howard Journal, 44(1). Coppen, A. and Farmer, R. (1998). Suicide mortality in patients on lithium maintenance therapy, Journal of Affective Disorders, 50, pp.261-267. Dooley, E. (1994). Unnatural death in prison: is there a future?, in A. Liebling and T. Ward (eds.) Deaths in Custody: International Perspectives, pp.28-36. London: Institute for the Study and Treatment of Delinquency. Finch, J. (1984). It’s great to have someone to talk to: the ethics and politics of interviewing women, in C. Bell and H. Roberts (eds.), Social Researching: Politics, Problems, Practice. London: Routledge and Kegan Paul. Foster, T., Gillespie, K. and McClelland, R. (1997). Mental disorders and suicide in Northern Ireland, British Journal of Psychiatry, 170, pp.447-452. Hawton, K., Kingsbury, S., Steinhardt, K., James, A. and Fagg, J. (1999). Repetition of deliberate self-harm by adolescents: the role of psychological factors, Journal of Adolescence, 22(3), pp.369-377. Isacsson, G. and Rich, C.L. (2001). Management of patients who deliberately harm themselves, British Journal of Psychiatry, 322(7280), pp.213-215. Kuiper, N.A. and Rogers, T.B. (1979). Encoding of personal information: self-other differences, Journal of Personality and Social Psychology, 37(4), pp.499-514. Lee, R.M. (1993). Doing Research on Sensitive Topics. London: Sage. Marshall, M.N. (1996). Sampling for Qualitative Research, Family Practice, 13(6), pp.522-525. Ovenstone, I.K. and Kreitman, N. (1974). Two syndromes of suicide, British Journal of Psychiatry, 124(0), pp.336-345. Marshall, C. and Rossman, G.B. (1995). Designing Qualitative Research, 2nd ed. London: Sage. Mohino Justes, S., Ortega-Monasterio, L., Planchat Teruel, L.M. et al. (2004). Discriminating deliberate self-harm in young prison inmates through personality disorder, Journal of Forensic Science, 49(1). References Pannell, J., Howells, K. and Day, A. (2003). Prison officer’s beliefs regarding self-harm in prisoners: an empirical investigation, International Journal of Forensic Psychology, 1(1), pp.103-109. Rossman, G.B. and Rallis, S.F. (1998). Learning in the Field. Thousand Oaks: Sage Publications. Spencer, G. (1982). Methodological issues in the study of bureaucratic elites: a case study of West Point, in R.G. Burgess (ed.), Field Research: A Sourcebook and Field Manual. London: George Allen and Unwin. Taylor, S.J. and Bogdan, R. (1984). Introduction to Qualitative Research. New York: Wiley. Verkes, R.J., Van Der Mast, R.C., Hengeveld, M.W., Tuyl, J., Zwinderman, A.H. and Van Kempen, G. (1998). Reduction of paroxetine of suicidal behaviour in patients with repeated suicide attempts, but not major depression, American Journal of Psychiatry, 155, pp.543-547. Wessely, A., Akhurst, R., Brown, I. and Moss, L. (1996). Deliberate self-harm and the probation service: an overlooked public health problem, Journal of Public Health Medicine, 18(2), pp.129-132. Winkler, J. (1987). The fly on the wall of the inner sanctum: observing company directors at work, in G. Moyser and M. Wagstaffe (eds.), Research Methods for Elite Studies. London: Allen and Unwin. Appendices A: The MCMI II Questionnaire Sample 1. When I am disrespected by others in the social environment, I often exhibit hostile behaviours. True or False 2. I often find myself experiencing sudden outbursts of sadness or grief even when the environment is not providing negative circumstances. True or False 3. I generally feel that I have more strengths and character (integrity) than most everyone else I know. True or False 4. I prefer to avoid social situations rather than engage in social scenarios True or False Appendices B: Sample Questionnaire for Inmate Participants 1. When I feel negative emotions (hostility, aggression, frustration, etc.) I often find release from these feelings with self-harm behaviours. 1 2 3 4 5 6 7 8 9 10 2. I believe that I have excellent control over my emotional states and am not prone to sudden changes in emotional feelings. 1 2 3 4 5 6 7 8 9 10 3. I utilise self-harm behaviours to change my current incarceration status and temporarily escape my cell conditions. 1 2 3 4 5 6 7 8 9 10 Read More