Inflammatory agents and use of force: prevalence amongst self-injurious behaviour incidents

Research Highlights: Among self-injurious behaviour incidents, 14% had an accompanying use of force and 7% had an identified use of inflammatory agents, indicating that force is not commonly used to manage these situations.

The Correctional Service of Canada (CSC) has a responsibility to ensure offenders and correctional staff are safe from harm. However, CSC is equally responsible for their responses to incidents where individuals' safety is comprised. While there are policies to ensure that the use of force is limited, there are some situations where it is required to mitigate the risk to the individual, bystanders, and/or staff, including to stop self-injurious behaviour (SIB) or prevent suicide. This study examined the application of inflammatory agents^{Footnote 1} as a use of force measure when responding to incidents where individuals were self-harming or suicidal.

All SIB incidents (N = 3,332) that occurred between April 1, 2018 to March 15, 2020 were included in this study. SIB incidents included self-injury/self-injurious behaviour, suicide attempts, and suicide events. SIB incidents were examined across security level, region, facility type, SIB behaviour, SIB sub-types, types of force measures used, and number of force options employed. Information related to level of review and review assessments, as well as whether the use of inflammatory agents were the initial, intermediate, or final response option to suicide and self-harm incidents were also examined.

Overall, SIB incidents represented 7% of all incidents. Among SIB incidents, 14% (n = 471) had an accompanying use of force and 7% (n = 235) had an identified use of inflammatory agents. Physical handling and inflammatory agents were the most commonly used options in SIB incidents where there was a use of force. Among all SIB incidents, the most prevalent types of SIB reported were slashing and head banging, whereas strangulation and opening existing wounds had the highest proportion with an associated use of inflammatory agents.

Overall, the Prairie region had the largest proportion of SIB incidents; however, the Quebec region had the highest proportion of SIB incidents with an identified use of inflammatory agents. Over one-third of SIB incidents occurred in women's institutions; however, the number of SIB incidents with a use of inflammatory agents in women's institutions was much smaller than in men's institutions. Incidents that occurred in maximum security had the highest proportion of SIB incidents with an associated use of force or use of inflammatory agents.

Of the 69 SIB incidents where inflammatory agents were employed in conjunction with other use of force options, 78% (n = 54) had inflammatory agents as the first force option used. When assessing whether the force option(s) was limited to what was necessary and proportionate to manage the associated risk of the incident, concordance was 95% for reviews completed by the Institution and Region.

This study provided a descriptive overview of when the use of force and in particular, inflammatory agents are used as a response to SIB. The findings suggest that policy is being considered when deciding whether a use of force should be deployed. However, further qualitative review of SIB incidents with an identified use of inflammatory agents is required to better understand the nature of the behaviour and the circumstances of the event to determine if policy and Engagement and Intervention Model (EIM)^{Footnote 2} principles are being applied as specified.

Beauchamp, T., Cram, S., Smeth, A., & Farrell MacDonald, S. (2023). Inflammatory Agents and Use of Force: Prevalence amongst Self-injurious Behaviour Incidents (Research Report R-459).Ottawa, Ontario: Correctional Service of Canada.

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