A qualitative study of self-injurious behaviour in treatment centres

Non-suicidal self-injury (NSSI) may be defined as deliberate bodily harm or disfigurement without suicidal intent and for purposes not socially sanctioned. NSSI within correctional facilities is particularly challenging and results in substantial human and monetary costs. A series of reports on self-injury among offenders in non-treatment center facilities in the Correctional Service of Canada (CSC) has been completed. The purpose of the current study was to add to this research by examining the motivations, emotions, precipitating events, and substitutive behaviours related to NSSI in male offenders residing in treatment centres in order to inform interventions and management strategies.

Forty-one federally sentenced men participated in semi-structured interviews designed to assess their history of NSSI in-depth. Men were recruited from a forensic treatment centre in each of the five regions in CSC.

Coping was the most common reason cited for engaging in NSSI, with almost two-thirds of participants reported using this behaviour as a method of dealing with powerful or negative emotions. The second most common reason given was the use of NSSI to hurt themselves instead of acting on an urge to hurt someone else. Among only those participants who initiated their NSSI while in a CSC institution (19.5%), coping remained the most common motivation for the behaviour.

The most common emotions reported by the men prior to engaging in NSSI were anger and frustration, with about 40% of participants endorsing these emotions, followed by depression and sadness for 20% of participants. After engaging in NSSI, the most common emotion reported was relief, followed by regret. Thirty-two percent of participants stated they had experienced interpersonal conflict prior to engaging in NSSI and 16% reported self-injuring after experiencing a stressful event such as losing a possession or not being able to make a phone call.

Almost 42% of participants stated they tried expressing their emotions to avoid the use of NSSI. Approximately 29% of men stated they would engage in activities to distract themselves and to keep from self-injuring.

Individuals with more serious mental health issues (i.e., federal women offenders and men in treatment centres) appear to have a different profile of motivations and origins of NSSI compared to populations with fewer mental health issues. Factors related to offenders' response to incarceration are more frequently implicated in NSSI among men in non-treatment centres than among women or men in treatment centres. Assessment and treatment planning to address NSSI should consider when the behaviour was initiated and the reasons that individuals engage in these behaviours. Appropriate interventions would assist participants in identifying situations and events that put them at risk for using NSSI and teach alternative coping strategies to decrease the use of NSSI.

Power, J. & Beaudette, J. (2013). A Qualitative Study of Self-Injurious Behaviour in Treatment Centres (Research Report R-294).Ottawa, ON: Correctional Service of Canada.

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Prepared by: Jenelle Power