International journal of law and psychiatry
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Int J Law Psychiatry · Sep 2006
Deliberate self-harm and suicide attempt in custody: distinguishing features in male inmates' self-injurious behavior.
Self-injurious behavior involving deliberate self-harm and suicide attempts by inmates while under custodial authority is a major problem for prisons and jails (prevalence, legal obligation for suicide prevention, and stress for officers). The differentiation of "serious" vs. "non-serious" and often manipulative suicide attempts as distinct phenomena, each with its own clinical features, is controversially discussed in current literature and a challenge for every diagnostician. If distinct clinical presentations and histories can be observed, an estimation of the seriousness of each act of self-injurious behavior can be simplified, whereby appropriate treatment of the individual case becomes possible. ⋯ The PCL-R total score as well as PCL-R factor 1 showed a statistical trend for negative correlations with measures of seriousness. Inmates showing deliberate self-harm and suicide attempters seem to differ in a number of ways. Implications on how the individual prisoner should be treated are discussed.
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The role of the prison has changed, in some ways dramatically, over the last two decades. The prison population has grown and its composition has altered. There has been an increase in the depth and weight of imprisonment, and a hardening of its emotional tone. ⋯ There are new fantasies about, and constructions of, the prison's role, with little evidence to support such public and political dreams. Such sleights of hand are only possible without knowledge of the prison's interior life. Punitive prisons which treat prisoners, and possibly prison staff, unfairly and with little or no respect add to human suffering and do not address either the problem of crime or the problem of public fear.