| Summary: | There are a growing number of prisoners who self-harm in prisons in England and Wales. As the prisoners first means of support, prison staff play an important role in identifying and managing prisoners at risk of self-harm. In spite of the implementation of a prison self-harm pathway, self-harm continues to rise. The main purpose of this project was to identify and compare relevant attitudinal dimensions of custodial and health care staff who work with prisoners who self-harm in an Adult Male 'Local' Category B prison (referred to as the study prison). A case study methodology with a mixed method approach that includes a self-harm questionnaire (SHAS), semi-structured interviews and documentary evidence was used. Thirty-seven prison staff (14 nurses and 23 prison officers) completed the SHAS. Qualitative data were analysed using thematic analysis. Quantitative data were analysed using Windows Software Package for Social Sciences (SPSS) version 16. There were no significant differences between the SHAS scores of the nurses and prison officers. Nurses with a mental health registration, those with training in self-harm and non-uniform prison officers showed more empathy to prisoners who self-harm. Five themes were identified from the qualitative data. They were: understanding self-harm, building relationships, organisational issues, occupational issues and care management of self-harm. A high proportion of prison staff felt that they were poorly educated in self-harm and unsupported by management. There were also interdisciplinary conflicts amongst prison staff on how to manage self-harm and criticism of the current management framework. An effective prison management structure for prisoners at risk of self-harm was identified as one which encourages joint working and shared decision making amongst different agencies involved in the care of these prisoners and is supportive of all prison staff with regular access and updates to self-harm education.
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