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A National Survey of Self-Injurious Behavior in American Prisons

Published Online:1 Mar 2011https://doi.org/10.1176/ps.62.3.pss6203_0285

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. (Psychiatric Services 62:285–290, 2011)