Self-Injurious Behaviors in Prisons: A Nationwide Survey of Correctional Mental Health Directors

Thursday, October 27, 2011
Cover from Self-Injurious Behaviors in Prisons: A Nationwide Survey of Correctional Mental Health Directors
Kenneth L. Appelbaum, MD
University of Massachusetts Medical School
Robert Trestman, MD, PHD
University of Connecticut Health Center

Self-injurious behavior (SIB) by inmates has serious health, safety, operational, security and fiscal consequences. Serious incidents require a freeze in normal facility operations. Injuries that need outside medical attention create additional security risks, including potential escape attempts. The interruption of normal operations, diversion of staff, cost of outside care, and drain on medical and mental health resources all have significant fiscal consequences. This session will present the results and implications of a survey of the Mental Health Directors in all 51 state and federal prison systems on the extent of SIB by inmates, including incidence and prevalence, adverse consequences, and management.  Thirty-nine of the state and federal correctional systems (77%) responded to the survey. Fewer than 2% of inmates per year engage in SIB, but in 29 85%) of systems these events occur at least weekly to more than once per day. The highest rates of occurrence of these behaviors are in maximum security and lock-down units, and most often involve inmates with Axis II disorders. Despite the seriousness of the problem, systems typically collect little, if any, data on self-injurious behaviors, and management approaches lack widespread consistency.

Conference 
American Academy of Psychiatry and the Law 42nd Annual Meeting