Abstract

PurposeThis study examined the characteristics of men in prison who have a history of both self‐harm and violence (known as dual harm) and the extent to which demographic and criminogenic factors, in‐prison incidents, and self‐harm method could differentiate men who dual harm.MethodsOfficial prison sample data were examined for the period April 2010 to November 2017 (n = 965). Regression analysis of all custodial incidents, demographic and offending information, and imprisonment experience, was undertaken.ResultsSelf‐harm was associated with violence in prison, representing a 3.5‐fold risk of violence compared with men who did not self‐harm, after controlling for time in prison, age, and index offence. 60% of men who harmed themselves also engaged in custodial violence, while 32% who were violent also had a self‐harm event. After controlling for age at first incident, 11% of the sample had custodial history of dual harm and they accounted for 56% of all recorded custodial incidents. They had a high probability of property damage and fire setting in prison and spent 40% longer in custody. Men who dual harmed used a greater variety of self‐harm methods, with increased use of lethal methods.ConclusionDual harm is prevalent, particularly among those who harm themselves in prison. Men who dual harm contribute excessively to the overall incident burden in prison and demonstrate behavioural variability and risk regarding both violence and self‐harm. The findings challenge the usual distinctive management responses or that self‐harm or violence is solely the responsibility of health or justice, with greater integration required.

Highlights

  • There have been suggestions that suicidal behaviour may be ‘aggression turned inwards’ (Plutchik et al, 1989) – a proposition with limited ability to explain the wider phenomenon of dual harm or its development since dual-harm individuals appear qualitatively and quantitatively different from individuals that engage in sole harmful behaviours (O’Donnell et al, 2015)

  • This study aimed to examine the prevalence of a history of dual-harm behaviour and identify the distinct characteristics of men who dual harm in prison, using a complete prison sample for the first time

  • The results confirm that dual harm is prevalent within an early-stage prison setting, with 11% of prisoners having engaged in both self-harm and violence within custody

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Summary

Introduction

It has been established in the literature that a relationship exists between harmful behaviours, with self-harm acting as a precursor to violent behaviour, and vice versa (O’Donnell, Smith, & Waterman, 2015). There have been suggestions that suicidal behaviour may be ‘aggression turned inwards’ (Plutchik et al, 1989) – a proposition with limited ability to explain the wider phenomenon of dual harm or its development since dual-harm individuals appear qualitatively (e.g., methods used) and quantitatively (e.g., severity) different from individuals that engage in sole harmful behaviours (O’Donnell et al, 2015) It is not yet clear which primary theoretical framework – self-harm or violence – offers the best method for understanding dual harm, or whether a new theoretical model is required. Firesetting was identified among psychiatric patients who displayed both suicidal and violent behaviour (Plutchik et al, 1989), suggesting a pattern across populations

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