Effectiveness of Nonsuicidal Self-Injury Interventions Among Incarcerated Women in Correctional Facilities and Secure Settings: An Integrative Review

Abstract

Introduction: The number of women incarcerated in correctional facilities in Canada has increased over the years. There is also great concern regarding the prevalence of various forms of mental health needs among these women. The rate of self-inflicted injuries has been on the rise among incarcerated women in Canada. Research in the field of non-suicidal self-injury (NSSI) is faced with challenges of different terminologies and definitions used. This has also influenced the estimation of the prevalence of non-suicidal self-injury in the literature. It is also shown that the initiation and motive of NSSI differ from males to females which poses a challenge in determining the type of intervention that will be appropriate for specific individuals. Therefore, it is essential to identify interventions that are effective in managing NSSI among incarcerated women in correctional and secure settings. Objective: The purpose of this integrative review was to identify interventions that are effective for the treatment of NSSI among incarcerated women in correctional and secure settings. Gaps that require future research will also be outlined. Methodology: The integrative review method based on Whittemore and Knafl’s framework to systematically combine different study types (quantitative, qualitative, and mixed methods) was used. The databases searched included Medline, PubMed, SCOPUS, Web of Science, PsycINFO, Cochrane online library, CINAHL, and Google Scholar. Eleven papers were identified that met inclusion criteria. Descriptors Strong, Moderate or Weak were used to categorize the quality assessment of the included papers. Constant comparison method and thematic analysis were used in the process of data analysis. Results: The interventions for NSSI for incarcerated women identified as promising are (1) Dialectical Behavioural Therapy (DBT); (2) Group Cognitive Behavioural Therapy (Group CBT); (3) System Training for Emotional Predictability and Problem Solving (STEPPS); (4) staff training and support program; (5) positive and trustworthy prisoner-staff relationships ; and (6) the use of good-bye letters after therapy completion. Other forms of intervention noted are the algorithm of care, and psychodynamic interpersonal therapy (PIT). Conclusion: In as much as the interventions showed promise in their effect against NSSI, they are not without limitations. Although no evidence-based nursing interventions were identified for the treatment of NSSI among incarcerated women, the above-mentioned interventions are also implemented by nurses in their roles as front-line health professionals. There was no data supporting the effectiveness of gender-specific interventions for women who are incarcerated. The findings of this integrative review suggest the need for further research in this field to identify and implement appropriate interventions for the prevention and treatment of NSSI among this population.