The impact of exposure to self-harming behaviours on the psychological wellbeing of staff working in prisons and secure psychiatric hospitals: a systematic review

Purpose Self-harming rates in prisons and secure psychiatric hospitals are rising in the UK, with staff on the front line often being the first to respond to incidents. Working with individuals who purposely harm themselves can impact the psychological well-being of those responding to these behaviours, with some staff recognising that they felt traumatised following witnessing an act of self-harm. This paper aims to examine the impact of exposure to self-harming behaviours on the psychological well-being of staff working in prisons and secure psychiatric hospitals. Design/methodology/approach To obtain a more detailed understanding of the existing literature, the authors undertook a systematic review. Searches of ten electronic databases were conducted in 2021 to identify studies published in peer-reviewed journals since 1989. In all, ten studies with a total of 206 participants were included in the final review. Findings The findings of this study suggest that staff have different experiences, some of which are consistent with trauma responses. Findings from this review suggest that working closely with these behaviours can have an impact on psychological responses. Themes of immediate responses included fear and anxiety, anger and frustration, guilt and blame and stress and shock. Prolonged responses included desensitisation and detachment and flashbacks and nightmares. Originality/value The findings highlight that those working in prison settings are more likely to report desensitisation and detachment from emotions than those in secure psychiatric hospitals, who are more likely to report stronger emotional responses. Findings from this review should be interpreted with caution because of the limited amount of empirical evidence exploring staff’s responses when responding to and managing self-harming behaviours.