The Self-Harm Assessment and Data Analysis (SADA) Project was set up in Ireland in 2016 to provide robust information relating to the incidence and profile of self-harm within prison settings, as well as individual-specific and context-specific risk factors relating to self-harm. In addition, it examines patterns of repeat self-harm (both non-fatal and fatal). The Health Service Executive’s National Office for Suicide Prevention and the National Suicide Research Foundation assist the Irish Prison Service with data management, data analysis, and reporting. This article highlights findings from a report presenting data in the analysis of all episodes of self-harm across the Irish prison estate during the years 2020 and 2021.1

Episodes of self-harm

Between 1 January 2020 and 31 December 2021, there were 421 episodes of self-harm recorded in Irish prisons; these involved 217 individuals. The majority of prisoners who engaged in self-harm were male (79.0%), but taking into account the male prison population, the rate of self-harm among males was 2.8 per 100 prison population in 2020 and 2.3 per 100 prison population in 2021, with a decrease of 17.9% recorded between 2020 and 2021. Thirty-one female prisoners engaged in self-harm in 2020 and 14 in 2021, which equates to rates of 36.9 per 100 prison population in 2020 and 15.6 per 100 prison population in 2021, respectively.

Methods, severity, and intent

The most common method of self-harm recorded was self-cutting or scratching, which was present in 60.8% of all episodes in 2020 and in 62.7% of all episodes in 2021. The other common method of self-harm was attempted hanging, involved in 27.9% of episodes in 2020 and 15.9% of episodes in 2021. No medical treatment was required for almost one-half of episodes in 2020 (44.9%) and one-quarter of episodes in 2021 (24.0%). In 2020 and 2021, 44.5% and 55.6% of episodes, respectively, required minimal intervention or local wound management in the prison. One in 10 required hospital outpatient or accident and emergency department treatment in 2020 (n=23; 10.2%), while 1 in 20 required hospital outpatient or accident and emergency department treatment in 2021 (n=9; 4.6%). Self-harm episodes by male prisoners were associated with increased severity. One in 20 in 2020 and 1 in 10 in 2021 (4.4% versus 10.7%) episodes were deemed to have a high degree of suicidal intent.

Contributory factors

The most common contributory factors to self-harm are shown in Figure 1. The majority of contributory factors recorded related to mental health issues and poor coping/difficulties in managing emotions. Substance misuse, including drug use and drug seeking, was recorded in 4.5% of self-harm episodes in 2020 and 7.0% of episodes in 2021.

Other findings

• Other findings highlighted in the report include the following:
• Three-quarters (77.3% and 71.9%) of self-harm episodes involved prisoners in single cell accommodation in 2020 and 2021, respectively. In 2020, 52.1% of the overall prison population was accommodated in single cells, and 56.7% was accommodated in such cells in 2021.
• The rate of self-harm was higher among prisoners on remand or awaiting trial than among sentenced prisoners (3.0 versus 1.5 per 100 prisoners on remand or awaiting trial in 2020 and 3.1 versus 1.5 per 100 of this population in 2021).
• In line with findings from previous reports, substance misuse continues to be one of the factors associated with self-harm among the prison population in Ireland.

Figure 1: Most common contributory factors to self-harm in Irish prisons, 2020 and 2021
Source: Irish Prison Service et al. (2024)1

1     Irish Prison Service, National Office for Suicide Prevention and National Suicide Research Foundation (2024) Self-harm in Irish prisons 2020-2021 report. Fourth report from the Self-Harm Assessment and Data Analysis (SADA) project. Dublin: Irish Prison Service. Available from: https://www.drugsandalcohol.ie/41833/