By Laura Hemming.
“You’re not going to see him on your own, are you?”
It was my first day collecting data in prison and I was trying to navigate the complicated process of identifying a potential participant to meet and discuss my research with.
“No, no you’d be better off seeing John Smith [1]. He won’t give you any trouble, he’s lovely.”
As per my safety protocol, I logged onto the prison record management system to check his record for any sign that either of our safety could be compromised by meeting with him.
“Sorry”, I sheepishly replied, “It’s just that it says here that John shouldn’t be left alone with females. Also, it shows that last week he stabbed a nurse in the leg with a plastic knife. Do you think it’s safe for me to meet with him?”
Before I knew it, I was being ushered down to G wing and into a private room to meet with John and discuss my research. As it happens, John Smith was lovely, and as predicted, didn’t give me any trouble. This discrepancy between record notes and in-person demeanour was one I would soon become familiar with, and highlights the complexity of assessing for risk in a prison environment.
John Smith ended up being the first participant in my PhD study which explores the relationship between alexithymia, suicide and violence. Alexithymia is best explained by returning to the origins of the word which in Ancient Greek translates to ‘a’ (a lack of) ‘lexi’ (words) ‘thymia’ (for feelings). A wealth of research now exists to suggest that such an experience may relate to thoughts and behaviours associated both with suicide and violence, but to date, no such research exists with prisoners. My PhD therefore aims to explore this by i) interviewing both prisoners and prison staff about their experiences of alexithymia, suicide and violence and ii) administering questionnaires to prisoners to assess the quantitative relationship between these phenomena.
Others have noted in detail the challenges that are posed by conducting research in prison, such as issues with gaining access to participants and the oppressive and sometimes intimidating nature of the environment [2]. These challenges can feel even more overwhelming for Early Career Researchers (ECRs) who may have little experience in this environment. This blog will therefore give five top tips to ECRs who wish to research suicide in prison.
1. Gaining access
One of the biggest immediate challenges to conducting research in prison is gaining access. This requires forming relationships with staff members in prisons and persuading them that it will be beneficial to host your research study. This can be difficult to do when you are not offering anything concrete, such as a psychological therapy, for participants. Despite this, I found it helpful to offer to feedback results and practice recommendations directly to prison staff, through written reports alongside presentations at team meetings. I would suggest making your study the least onerous it can possibly be on staff, which in most cases will require gaining key access, to enable you to roam the prison freely without staff needing to escort you.
Once you have found a prison who are happy to host your research, make sure you begin the process for gaining access as soon as possible. Depending on the prison, this can be a lengthy process – for me, it took around 18 months! This can be challenging for PhD students whose research is often time-limited, therefore the sooner you can begin this process the better.
2. Ethical considerations
For any research involving collection of human data, ethical approval is required. For studies of suicide in prison, you are likely to need ethical approval from your host institution, the NHS and Her Majesty’s Prison and Probation Service (HMPPS).
It is important to consider, however, that there may be some exceptions required in order to conduct research in prison fairly and safely, which may differ from research with other populations. For instance, whilst it is usually custom to allow participants at least 24 hours to consider their participation in the study, I found during the course of my data collection, that this actually sometimes disadvantaged prisoners who wanted to take part in research but were unable to do so more than 24 hours later due to being transferred, released or becoming unwell. Therefore, in this case, it was actually more ethical to allow potential participants the chance to agree to participate at the same time as receiving information about the study, though of course still giving the option for participants to wait 24 hours before consenting.
It is usually deemed unethical to allow the research team to make first contact with potential participants due to concerns that they may place undue emphasis on the study or coerce participants to take place. In prison research, the alternative is relying on prison staff to make this approach. However, this could itself be considered coercive due to the complex power imbalance that exists between prisoners and prison staff. Therefore, it may be more appropriate for a member of the research team to make the first approach to potential participants.
My final piece of advice for ethical approvals, is to ensure that you select an NHS REC committee listed as having ‘prison expertise’. This may necessitate travel or online REC meetings, but in my opinion this is worth it for the level of understanding of prison research which others may not be familiar with.
3. Lived experience
As part of my PhD I recruited a group of seven people, via existing networks, probation teams and charity organisations, who had experience of residing in prison to advise on and co-research several aspects of my PhD. Whilst funding is often limited for patient and public involvement activities in doctoral research, I would strongly advise seeking additional resources to support such activities.
I personally had not been inside a prison before starting my PhD so working with a group of people who possessed this experience transformed several aspects of my PhD. Most importantly, being armed with greater knowledge and understanding of what to expect helped me to adapt to this challenging environment through instilling confidence in me. Moreover, the group created a letter to be given to potential participants explaining who they were and what they had done to help with the study. In my experience this was an instant rapport builder and I believe led to an enhanced recruitment rate to all of my studies. Finally, co-analysing qualitative data with a contributor with lived experience was a novel, rewarding experience both in terms of the skills gained as a researcher as well as the authenticity of the final paper.
4. Don’t compromise on safety
Conducting research in prison can be tough, and this is compounded by researching and talking with people who are often considered ‘high risk’ due to current thoughts of suicide. Researching suicide makes it likely that at some point you will need to pass on risk information to prison staff about prisoners’ safety. This can bring with it a set of difficult decisions, including a tension between adhering to your duty to keep participants safe as well as preserving their right to anonymity and confidentiality. My advice is not to be over cautious with the information you pass on to staff. It is easy to get weighed down into conversations about the ‘authenticity’ of the information you have received, or how likely you think the participant is to act on the thoughts disclosed, but remember it is not your duty to judge the authenticity of suicidal thoughts, simply your duty to pass these on to staff. Draw up a risk and safety protocol early on and ensure you always have a printed copy with you to which you can refer staff if necessary.
It is also important not to compromise your own safety. It can be tricky to strike a balance between maintaining your safety whilst remaining flexible enough to be able to speak confidentially with participants. For me, I found it useful to ensure that one of my supervisors knew when I was due to be entering and leaving prison, and that they were contactable in this time to discuss issues of risk. Other safety measures may include becoming radio trained, or attending induction talks on safety and self-defence held by host prisons.
5. Stay connected
I sometimes found that researching in a prison environment could be a somewhat lonely endeavour. The challenges you face can sometimes feel quite unique and different from those in your cohort. Try to ensure that – where available – you have regular clinical calls with supervisors, to allow you the space to offload what can be sometimes distressing experiences. If possible, try to also find a group of peers that research in prison too, as this can be a great source of support in overcoming challenges.
Researching suicide in prison can be challenging, but it is also a rewarding and worthwhile endeavour, not least because suicide rates in prison are on the rise. I’d be more than happy to chat to anybody considering researching this area to share tips and experiences – feel free to get in touch!
References
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- Names changed to preserve anonymity.
- Bosworth, M., Campbell, D., Demby, B., Ferranti, S. M., & Santos, M. (2005). Doing prison research: Views from inside. Qualitative inquiry, 11(2), 249-264.
Laura Hemming (@LHemming123) is a PhD student at the University of Manchester and a project co-ordinator for The Mental Elf.
*Featuring Photo by Alfaz Sayed on Unsplash.
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