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Women Offender Programs and Issues

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Report on Self-Injurious Behaviour in the Kingston Prison for Women

Section 5: Conclusion

    The most important finding of this study is the extent to which security issues supersede mental health issues. With both self-injurious and suicidal behaviour, responsibility has largely remained with the CX staff. This situation has involved inordinate stress for these staff members who are not trained in mental health issues. The primary concerns to date have been security/administrational versus treatment.

    The prison must begin utilizing the resources they have at their disposal. Many of the recommendations made in this report are the ones that have been voiced by the two prison psychologists and health care services staff for quite some time. The fact that these voices have not been heard or acted upon, reflects the historic trend towards a reactive rather than a proactive stance to mental health issues. The psychologists have largely been relegated to a position of "putting out fires" as opposed to being included in policy making. This trend must end. It must be recognized that every policy has a potential impact on the emotional well-being of prisoners and, as such, the psychologists must have equal if not greater power than security in the policy process. Input from the psychology department could avert many of the problems presently experienced when new policy is implemented.

    Secondly, the overwhelming number of prisoners who have experienced childhood abuse must be addressed. The prison system is dealing with women who have as children experienced loss of control/determination over the fundamental right to their bodies. Many of the current practices in the prison result in these women once again experiencing feelings of helplessness and powerlessness. This is a difficult situation for a non-victimized individual; for those who have been victimized, the replication of feelings of defenselessness experienced as a child is untenable. In the absence of systematic change, these women, upon completion of their sentence, will go out into the world doubly victimized. It is unreasonable to expect that after such an experience they can reach their full potential as citizens. In addition, it must be recognized that the recommendations contained in this report are interim measures. Ultimately, provision must be made for those offenders who have experienced childhood abuse to be housed in facilities directed solely toward treatment. Until that point, any steps taken must be considered "band-aid" measures.

    Addressing mental health issues must ultimately involve changes in the distribution of staff. The Mission Statement acknowledges that if offenders are assisted in developing social and living skills their potential to become law-abiding citizens will be enhanced (p. 10). This goal can only be achieved by ensuring that individuals the prisoners come into daily contact with are trained in promoting these skills. The addition of social workers to complement the CX staff would provide positive interactions for the prisoners and would alleviate the stress the CX staff currently experiences from being forced into the role of social worker. As well, many of the recommendations made in this report involve the utilization of health care services personnel. The increase in use of this service through the implementation of the recommendations must be provided for through the addition of nursing staff.

    By implementing the proposed recommendations, the number of situations which aggravate feelings of helplessness and lack of control will be reduced. This, in turn, will reduce the occurrence of self-injurious behaviour. The proposed shift from viewing self-injurious behaviour as a security/administrational concern to viewing it as under the domain of psychology/health care services should also reduce the rate of occurrence. The proposed transfer to health care services as opposed to segregation will provide structured opportunities for prisoners to work through emotional difficulties in a positive atmosphere with the person(s) best suited to meet individual needs. The possibility of immediate support from peers, nursing staff, and/or psychologists offers an alternative to self-injury as a method for coping. It has been my experience that when a woman who self-injures is provided with alternative ways to reduce anxiety and deal with feelings of helplessness/powerlessness she will utilize the more health-oriented option. Thus, I am confident that the proposed changes will be successful in the reduction of this behaviour.

    Self-injury is a symptom of distress resulting from childhood sexual abuse. Its occurrence must be viewed by Correctional Service as an indication of the emotional pain experienced by many in the population it serves. The Mission Statement reflects a philosophy which has moved from a punishment model to a rehabilitative model. To achieve this, the impact of such factors as childhood abuse must be taken into account, both as playing a part in the woman entering the penal system and as an important issue to be addressed in attempting to assure that upon release the woman does not return. It is only when the Mission Statement’s philosophy is reflected in practice that offenders will be allowed the opportunity to serve their sentences in "a meaningful and dignified manner" (p. 7).