| Summary: | Women in custody represent the minority (5%) of offenders within the overall prison population, although in 2016 women carried out 21% of all acts of self-harm that took place in custody in England and Wales (Ministry of Justice, 2016). To date, reviews of the literature have not considered in detail the role prison peer support may play for women who self-harm in custody. This thesis from a gendered perspective, explores the perceptions and experiences of the Listeners Scheme as a form of peer support and its contribution to supporting women to manage their self-harm in custody. Perspectives are sought from prisoners, staff and listeners as part of an in-depth case study design. Conversely, as an established prison peer support scheme for over two decades, research on the Listener Scheme and its contribution to the support of women who self-harm in custody has yet to be paid significant attention. The research employed a mixed methods approach with a quantitative questionnaire and a variety of qualitative data collection tools, which included a focus group, semi-structured interviews, and observations of the prison site. This thesis proposes the implementation of the Island Model for women who self-harm in custody. Women in the current research prioritised professional support for self-harm above peer support (Listener Scheme) which was an unexpected finding when compared with previous research. This finding led to the development of the Island Model - which includes professional and Listener support - as a way of understanding the value of a multi-disciplinary approach for women who self- harm in custody. Findings also support a gendered approach for women who self-harm in custody and in particular, that the Listener Scheme should incorporate gender-specific elements such as the difficulties women experience with men and the displacement of their mother role to support women who self-harm in custody. It is suggested that these elements should be given a significant focus by the prison estate, to reduce the potential triggers for self-harm for this specific group. The original contributions to knowledge of this thesis is as follows: - The development of the Island Model for understanding how the prison environment in which peer support sits can better support women who self-harm in custody. - Women prioritised professional support for self-harm above peer support (Listener Scheme) when this was provided within a prison site that operates a Therapeutic Community. It is therefore suggested that listeners and staff members should work more closely together to support self-harm, whilst maintaining the confidentiality ethos of the Listener Scheme. - A multi-disciplinary approach for women who self-harm in custody needs to be inclusive of support from staff and peers. - A gendered approach within the Listener Scheme for women who self-harm in custody needs to reflect women's difficulties with men, the displacement of their mother role and their desire for attachment in custody.
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