{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:45:41Z","timestamp":1787021141224,"version":"build-2736575974"},"reference-count":89,"publisher":"Royal College of Psychiatrists","issue":"4","license":[{"start":{"date-parts":[[2022,6,6]],"date-time":"2022-06-06T00:00:00Z","timestamp":1654473600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["BJPsych open"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:sec id=\"S2056472422000709_sec_a1\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Self-harm, including suicide, is common among prisoners. Staff attitudes and perceptions regarding self-harm may affect quality of care and patient safety.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472422000709_sec_a2\">\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To systematically review the experiences, perceptions and attitudes of staff in adult prisons regarding self-harm.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472422000709_sec_a3\" sec-type=\"methods\">\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>Systematic searches of EMBASE, Medline, PsycINFO and CINAHL databases were conducted, and supplemented by hand-searching and grey literature review, to identify relevant English-language articles published since the year 2000. Articles were screened by two authors and evaluated with standardised quality appraisal tools. Qualitative data were analysed thematically, whereas quantitative data were narratively synthesised because of high study heterogeneity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472422000709_sec_a4\" sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Two thousand articles were identified, of which 32 were included, involving 6389 participants from five countries. Most studies were moderate (\n                      <jats:italic>n<\/jats:italic>\n                      = 15) or poor (\n                      <jats:italic>n<\/jats:italic>\n                      = 10) quality, and seven were rated as good quality. Staff frequently witnessed self-harm and described multiple perceived risk factors and causes of this. Perceptions that self-harm is \u2018manipulative\u2019 or \u2018attention-seeking\u2019 were associated with hostility toward prisoners and lower quality of care. Perceived barriers to preventing and managing self-harm included low staffing levels, prison environments and culture, poor staff confidence and insufficient training. The importance of multidisciplinary teamwork and building staff\u2013prisoner relationships were highlighted. Staff occasionally experienced intense psychological reactions to self-harm, which resulted in adaptive or maladaptive coping that influenced their capacity to care.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472422000709_sec_a5\" sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>There are mixed attitudes and perceptions toward self-harm among prison staff. Further training, support and resources are required to protect staff's well-being and improve self-harm prevention and management in prisons.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1192\/bjo.2022.70","type":"journal-article","created":{"date-parts":[[2022,6,6]],"date-time":"2022-06-06T03:01:59Z","timestamp":1654484519000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":23,"title":["A systematic review and mixed-methods synthesis of the experiences, perceptions and attitudes of prison staff regarding adult prisoners who self-harm"],"prefix":"10.1192","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9879-9292","authenticated-orcid":false,"given":"Thomas","family":"Hewson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerry","family":"Gutridge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zara","family":"Bernard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn","family":"Kay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6455-1360","authenticated-orcid":false,"given":"Louise","family":"Robinson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"170","published-online":{"date-parts":[[2022,6,6]]},"reference":[{"key":"S2056472422000709_ref4","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.107.046490"},{"key":"S2056472422000709_ref3","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(17)30430-3"},{"key":"S2056472422000709_ref35","unstructured":"35 QSR International Pty Ltd. NVivo for Windows (Version 12). QSR International Pty Ltd, 2018 (https:\/\/www.qsrinternational.com\/nvivo-qualitative-data-analysis-software\/home)."},{"key":"S2056472422000709_ref36","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-8-45"},{"key":"S2056472422000709_ref53","doi-asserted-by":"publisher","DOI":"10.1080\/14999013.2004.10471195"},{"key":"S2056472422000709_ref47","doi-asserted-by":"publisher","DOI":"10.1002\/9780470661444.ch16"},{"key":"S2056472422000709_ref14","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2015-009749"},{"key":"S2056472422000709_ref6","unstructured":"6 Her Majesty's Prison & Probation Service, Ministry of Justice. Safety in Custody Statistics, England and Wales: Deaths in Prison Custody to December 2021, Assaults and Self-Harm to September 2021. Ministry Of Justice, 2022 (https:\/\/www.gov.uk\/government\/statistics\/safety-in-custody-quarterly-update-to-september-2021\/safety-in-custody-statistics-england-and-wales-deaths-in-prison-custody-to-december-2021-assaults-and-self-harm-to-september-2021)."},{"key":"S2056472422000709_ref68","doi-asserted-by":"publisher","DOI":"10.1177\/088626095010004001"},{"key":"S2056472422000709_ref73","doi-asserted-by":"publisher","DOI":"10.1108\/14636646200200023"},{"key":"S2056472422000709_ref82","doi-asserted-by":"publisher","DOI":"10.1093\/occmed\/kqx091"},{"key":"S2056472422000709_ref49","doi-asserted-by":"publisher","DOI":"10.1080\/14789949.2017.1421248"},{"key":"S2056472422000709_ref11","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)61141-6"},{"key":"S2056472422000709_ref27","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctcp.2005.05.005"},{"key":"S2056472422000709_ref81","doi-asserted-by":"publisher","DOI":"10.1080\/01612840.2018.1534911"},{"key":"S2056472422000709_ref88","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(20)30241-8"},{"key":"S2056472422000709_ref12","volume-title":"Preventing Suicide in England: A Cross-Government Outcomes Strategy to Save Lives","year":"2012"},{"key":"S2056472422000709_ref2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)62118-2"},{"key":"S2056472422000709_ref31","doi-asserted-by":"publisher","DOI":"10.1111\/jan.12451"},{"key":"S2056472422000709_ref43","doi-asserted-by":"publisher","DOI":"10.1111\/lcrp.12025"},{"key":"S2056472422000709_ref32","unstructured":"32 Critical Appraisals Skills Programme (CASP) UK. CASP Checklists. CASP UK, 2018 (https:\/\/casp-uk.net\/casp-tools-checklists)."},{"key":"S2056472422000709_ref58","doi-asserted-by":"publisher","DOI":"10.1177\/0093854810385886"},{"key":"S2056472422000709_ref72","doi-asserted-by":"publisher","DOI":"10.1080\/14999013.2013.832442"},{"key":"S2056472422000709_ref23","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2850.2007.01102.x"},{"key":"S2056472422000709_ref5","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)67325-4"},{"key":"S2056472422000709_ref26","doi-asserted-by":"publisher","DOI":"10.1097\/00063110-200508000-00005"},{"key":"S2056472422000709_ref51","doi-asserted-by":"publisher","DOI":"10.1108\/JCP-02-2016-0007"},{"key":"S2056472422000709_ref62","doi-asserted-by":"publisher","DOI":"10.1891\/1559-4343.20.1.27"},{"key":"S2056472422000709_ref75","volume-title":"Self-Harm by Adult Men in Prison: A Rapid Evidence Assessment","author":"Pope","year":"2018"},{"key":"S2056472422000709_ref50","doi-asserted-by":"publisher","DOI":"10.1177\/1477370811413804"},{"key":"S2056472422000709_ref87","doi-asserted-by":"publisher","DOI":"10.1192\/bjb.2020.83"},{"key":"S2056472422000709_ref7","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijlp.2017.10.005"},{"key":"S2056472422000709_ref30","first-page":"103","article-title":"Prison officer's beliefs regarding self-harm in prisoners: an empirical investigation","volume":"1","author":"Pannell","year":"2003","journal-title":"Int J Forensic Psychol"},{"key":"S2056472422000709_ref63","doi-asserted-by":"publisher","DOI":"10.1177\/1078345809331444"},{"key":"S2056472422000709_ref10","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)31045-0"},{"key":"S2056472422000709_ref42","unstructured":"42 Marzano, L . Self-harm in a men's prison: staff's and prisoners\u2019 perspectives . D Phil doctoral thesis Department of Psychology, Middlesex University, 2007."},{"key":"S2056472422000709_ref86","doi-asserted-by":"publisher","DOI":"10.1080\/14789949.2010.518245"},{"key":"S2056472422000709_ref18","doi-asserted-by":"publisher","DOI":"10.1016\/S0020-7489(99)00057-7"},{"key":"S2056472422000709_ref54","doi-asserted-by":"publisher","DOI":"10.1177\/1078345819879752"},{"key":"S2056472422000709_ref1","volume-title":"Guide to Safety in Custody Statistics","year":"2010"},{"key":"S2056472422000709_ref57","volume-title":"Research Findings: Promoting Resilience in Prison Staff","author":"Slade","year":"2013"},{"key":"S2056472422000709_ref79","volume-title":"Healthy Work: Stress, Productivity, and the Reconstruction of Working Life","author":"Karasek","year":"1990"},{"key":"S2056472422000709_ref89","article-title":"Scoping review of mental health in prisons through the COVID-19 pandemic","volume":"11","author":"Johnson","journal-title":"BMJ Open"},{"key":"S2056472422000709_ref80","doi-asserted-by":"publisher","DOI":"10.1037\/0021-9010.86.3.499"},{"key":"S2056472422000709_ref13","volume-title":"Competency and Qualities Framework"},{"key":"S2056472422000709_ref44","doi-asserted-by":"publisher","DOI":"10.1002\/cbm.795"},{"key":"S2056472422000709_ref76","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-012-0632-4"},{"key":"S2056472422000709_ref16","doi-asserted-by":"publisher","DOI":"10.1016\/S0020-7489(03)00054-3"},{"key":"S2056472422000709_ref65","doi-asserted-by":"publisher","DOI":"10.1108\/17556221111194518"},{"key":"S2056472422000709_ref29","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2850.2007.01052.x"},{"key":"S2056472422000709_ref24","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2850.2002.00512.x"},{"key":"S2056472422000709_ref38","doi-asserted-by":"publisher","DOI":"10.1186\/s12914-017-0136-0"},{"key":"S2056472422000709_ref78","doi-asserted-by":"publisher","DOI":"10.1177\/0093854800027002002"},{"key":"S2056472422000709_ref20","doi-asserted-by":"publisher","DOI":"10.1016\/j.hsag.2016.08.001"},{"key":"S2056472422000709_ref46","first-page":"34","article-title":"Self-harm and suicide at Grendon Therapeutic Community Prison","volume":"173","author":"Rivlin","year":"2007","journal-title":"Prison Serv J"},{"key":"S2056472422000709_ref25","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2648.2005.03344.x"},{"key":"S2056472422000709_ref69","doi-asserted-by":"publisher","DOI":"10.1111\/papt.12113"},{"key":"S2056472422000709_ref21","doi-asserted-by":"publisher","DOI":"10.1111\/j.1447-0349.2008.00533.x"},{"key":"S2056472422000709_ref22","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2011.08.024"},{"key":"S2056472422000709_ref71","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1111\/j.2044-8260.2010.02007.x","article-title":"The impact of prison staff responses on self-harming behaviours: prisoner's perspectives","volume":"51","author":"Ciclitira","year":"2012","journal-title":"Br J Clin Psychol"},{"key":"S2056472422000709_ref55","doi-asserted-by":"publisher","DOI":"10.1108\/JACPR-08-2014-0133"},{"key":"S2056472422000709_ref66","doi-asserted-by":"publisher","DOI":"10.3109\/09638237.2012.734645"},{"key":"S2056472422000709_ref56","doi-asserted-by":"publisher","DOI":"10.1002\/ab.20168"},{"key":"S2056472422000709_ref61","doi-asserted-by":"publisher","DOI":"10.1080\/09515070600811824"},{"key":"S2056472422000709_ref59","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijlp.2019.101490"},{"key":"S2056472422000709_ref70","volume-title":"Mental Health in Prisons. Palgrave Studies in Prisons and Penology","author":"Mills","year":"2018"},{"key":"S2056472422000709_ref74","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(20)30190-5"},{"key":"S2056472422000709_ref45","doi-asserted-by":"publisher","DOI":"10.1097\/JFN.0b013e31827a5984"},{"key":"S2056472422000709_ref37","first-page":"164","volume-title":"Systematic Reviews in the Social Sciences","author":"Petticrew"},{"key":"S2056472422000709_ref33","volume-title":"Study Quality Assessment Tools"},{"key":"S2056472422000709_ref19","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2923.1981.tb02500.x"},{"key":"S2056472422000709_ref8","volume-title":"The Cost of Prison Suicide: Research Briefing","year":"2016"},{"key":"S2056472422000709_ref39","volume-title":"Preventing Prison Suicide: Staff Perspectives","year":"2017"},{"key":"S2056472422000709_ref41","volume-title":"Self-Inflicted Deaths in NOMS\u2019 Custody amongst 18\u201324 Year Olds","author":"Ludlow","year":"2015"},{"key":"S2056472422000709_ref64","volume-title":"An Evaluation of the Safer Locals Programme","author":"Liebling","year":"2005"},{"key":"S2056472422000709_ref40","doi-asserted-by":"publisher","DOI":"10.1002\/cbm.777"},{"key":"S2056472422000709_ref60","unstructured":"60 Wood-Schultz, T . Variability in personal characteristics among professional staff providing suicide prevention responses in correctional settings. Doctoral thesis, Capella University, 2012."},{"key":"S2056472422000709_ref34","unstructured":"34 Hong, QN , Pluye, P , F\u00e0bregues, S , Bartlett, G , Boardman, F , Cargo, M , Mixed Methods Appraisal Tool (MMAT) Version 2018. McGill University, 2018 (http:\/\/mixedmethodsappraisaltoolpublic.pbworks.com\/w\/file\/fetch\/127916259\/MMAT_2018_criteria-manual_2018-08-01_ENG.pdf)."},{"key":"S2056472422000709_ref85","volume-title":"Self-Harm in Over 8s: Short-Term Management and Prevention of Recurrence","year":"2004"},{"key":"S2056472422000709_ref67","unstructured":"67 Ward, CJ . Women's imprisonment, self-harm and emancipatory research: Developing a framework for transformative research in a women's prison. Doctoral thesis, School of Applied Social Science, Durham University, 2014."},{"key":"S2056472422000709_ref28","doi-asserted-by":"publisher","DOI":"10.1046\/j.1471-6712.2003.00227.x"},{"key":"S2056472422000709_ref83","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-13-82"},{"key":"S2056472422000709_ref77","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.v69n1107"},{"key":"S2056472422000709_ref84","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2017.01.003"},{"key":"S2056472422000709_ref52","doi-asserted-by":"publisher","DOI":"10.1080\/14789949.2017.1331369"},{"key":"S2056472422000709_ref15","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2005.07.007"},{"key":"S2056472422000709_ref9","doi-asserted-by":"publisher","DOI":"10.1002\/cbm.2103"},{"key":"S2056472422000709_ref48","doi-asserted-by":"publisher","DOI":"10.1080\/14789940802377114"},{"key":"S2056472422000709_ref17","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2850.2002.00473.x"}],"container-title":["BJPsych Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S2056472422000709","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,6,6]],"date-time":"2022-06-06T03:02:24Z","timestamp":1654484544000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S2056472422000709\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,6]]},"references-count":89,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2022,7]]}},"alternative-id":["S2056472422000709"],"URL":"https:\/\/doi.org\/10.1192\/bjo.2022.70","relation":{},"ISSN":["2056-4724"],"issn-type":[{"value":"2056-4724","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,6,6]]},"assertion":[{"value":"Copyright \u00a9 The Author(s), 2022. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e102"}}