‘Prison has a massive impact on you, good and bad’

Reducing self-harm and violence continues to be a priority for His Majesty’s Prison and Probation Service (HMPPS). When individuals engage in both harmful behaviours, this is known as dual harm. Although a plethora research has explored reduction strategies for self-harm and violence separately, there have been limited studies addressing dual harm behaviours. This study aimed to identify themes that contribute to the reduction of dual harm among adult males living in prison. This study utilised a qualitative approach, involving semi-structured interviews with 12 adult male prisoners residing in a Long-Term High Security prison in England who had engaged in dual harm behaviours. Three interlinking themes were developed that appear salient in the reduction of dual harm risk: a decent and safe environment; relational connections; and personal growth. These themes were interconnected, with no one theme more salient than the other. Within each contributing factor, sub-themes were developed, offering a holistic view of dual harm reduction. These results highlight the relationship between the individual and organisational processes that support them in developing the skills to reduce their risk of dual harm. To support the reduction of dual harm, prisons require systematic changes to enhance the environment, support the relational connections between staff, prisoners and the prisoners support networks, enabling the development of the individual skills to manage the pains of imprisonment, and ultimately make lasting pro-social changes.