Extrait

Background and study aims The female prison population is growing at a much faster rate than men in prison. Recent government policy has identified women prisoners as having special health and service needs which are currently not met. Repeated self-harm (SH) (including suicide attempts) has become a considerable problem amongst women prisoners. It is associated with psychosocial problems, depression and increased risk of suicide, which is far greater in women prisoners than women in the community. Interpersonal conflicts are the commonest cause of SH in women and nearly 50% report histories of domestic violence, and around a third, previous sexual abuse, including one incident of rape in 1 in 20 women. Women prisoners also have high rates of mental illness. Managing SH is a significant call on scarce resources. Currently, no solution for women who SH in prison have been evaluated; none focuses explicitly on women's needs and no methodology for follow up has been developed. In this study, we developed and began evaluating a targeted intervention for SH using Psychodynamic Interpersonal Therapy (PIT) which focuses on resolving women's interpersonal and emotional difficulties which drive them to harm themselves. We have tested how feasible and acceptable it is to deliver PIT in a prison. We now want to find out how well PIT works for women prisoners with a recent history of repeat self-harm. Who can participate? Female prisoners aged 18-65 who have committed an act of self-harm in the previous month are eligible to participate in the study. What does the study involve? Participants will be randomly assigned to receive 4-8 sessions of PIT or control therapy (AC) after they have completed the initial assessments. We shall find out women's thoughts of suicide & SH, the number and severity of SH events at the start of the study, after therapy and 6 months later. We test out methods of following women for 6 months and test ways to collect information on use of prison resources resulting from women's SH. What are the possible benefits and risks of participating? This study may reduce suicidal thoughts and risk, and improve female prisoners' self-harm behaviour. Secondary benefits of this will be to improve safety and quality of life for female offenders, help the prison system improve care and treatment and provide women with equal opportunity to get SH therapies. The potential risk to women who participate in the PIT treatment group may be that if they explore their interpersonal problems perhaps for the first time this may bring out their negative past experiences and feelings, worsen their distress which could subsequently increase their self-harming behaviours. However, by engaging in a short-term therapy which focuses on women's distress, we hope to help women offenders self-manage their SH longer term. Where is the study run from? The study is run from Styal, Foston Hall and Newhall prisons, UK. When is study starting and how long is it expected to run for? The recruitment started in January 2013 and the study will run until June 2015, although we will be ending recruitment in September 2014. Who is funding the study? The study is funded by the National Institute for Health Research (NIHR), UK. Who is the main contact? Dr Tammi Walker [email protected]

Critère d'inclusion

• Mental Health Research Network - Suicide and self-harm

Liens

• isrctn
• ictrp