Women in prison who have experienced the care system as children report using self-harm as a way to communicate and stop the pain in their lives, says new research from LJMU, Lancaster and Bristol universities.

Self-harm incidents in custody in England and Wales have recently reached a record high, increasing particularly in women’s prisons. This research, funded by the Nuffield Foundation, highlights the prevalence of self-harm among women with prior experience of care.

The research published today in Criminology & Criminal Justice, the journal of the British Society of Criminology, calls for urgent action to address system failures affecting those who have previously been in care. 

Self-harm incidents in custody in England and Wales reached a record high of 63,328 in the 12 months to December 2019, up 14% on the previous year, with an alarming 3,130 incidents per 1,000 prisoners in women’s establishments, compared with 650 per 1,000 in men’s.

'Urgent action'

Researchers carried out interviews with women, all of whom had been in care as children, across three closed prisons in England. Of the 37 interviewed, 17 raised self-harm and/or suicide as an issue: 14 reported self-harming and/or attempting suicide, and six women mentioned being ‘suicidal’.

Co-Author Dr Julie Shaw, a Senior Lecturer in Criminology at Liverpool John Moores University's School of Justice Studies, said: “We did not set out to explore the issue of self-harm, but it was an issue that many women chose to share. This evidence is deeply concerning and highlights the need for urgent action.”

Some women reported self-harming as a way of communicating distress. 

For Marlene [not her real name] (38), self-harm became the method of communicating to prison officers that she was struggling and in need of support.

“I’ll start crying and then I’ll self-harm and then I’ll explain,” she said. “But I don’t know how to say, ‘look I’m feeling really low, I’m struggling, I need help’, like verbally. I do that through actions.”

“Self-harm may be a practical alternative to verbal communication for women and those with a history of being let down may be particularly reluctant to trust the latest authority figures involved in their lives,” says the journal article.

'Cry for help'

Mandy (46), who entered care aged 11 following sexual abuse by a family member, noted that after being “passed from pillar to post” in care, and sexually abused by a support worker in one children’s home, “I didn’t want to work with any authority figures at all”.

Mandy describes both her self-harm and offending as “a cry for help” and a way of communicating trauma.

A further function of self-harm highlighted by the women was to ‘alleviate pain’. An absence of timely mental health support could lead to an increase in individuals attempting to alleviate psychological pain.

Joanne (39) entered care aged 13 following domestic violence at home, and describes her self-harm as a ‘control thing’ for when she got ‘angry or agitated’ and felt that she had more control over life in prison than she had in care.

'Listen without judgement'

The research suggests that while self-harm might begin as a method of alleviating pain, it could become something more serious and there was a clear theme of wanting ‘things to end’ when pain became unbearable.

Inadequate support in care and custody, a lack of mental health support, the absence of emotional support for the long-term impact of self-harm and the inability of the care system to provide safety were also common themes.

Mechanisms for tackling this must, say the researchers, involve listening to women without judgement, paying attention to their individual feelings and experiences, and crucially not creating further harm.

The study team call for far more investment in community-based alternatives to punishment for women who would not otherwise present a danger to others.

The open access article is part of a wider Nuffield Foundation-funded Disrupting the Routes between Care and Custody  study.

All names have been changed to protect the identity of participants.

Notes

The Nuffield Foundation is an independent charitable trust with a mission to advance social well-being. It funds research that informs social policy, primarily in Education, Welfare, and Justice. It also funds student programmes that provide opportunities for young people to develop skills in science and research. The Nuffield Foundation is the founder and co-funder of the Nuffield Council on Bioethics, the Ada Lovelace Institute and the Nuffield Family Justice Observatory. The Foundation has funded this project, but the views expressed are those of the authors and not necessarily the Foundation. Visit www.nuffieldfoundation.org