Self-injurious behavior (SIB) by inmates has serious health, safety, operational, security and fiscal consequences. Serious incidents require a freeze in normal facility operations. Injuries that need outside medical attention create additional security risks, including potential escape attempts. The interruption of normal operations, diversion of staff, cost of outside care, and drain on medical and mental health resources all have significant fiscal consequences. This session will present the results and implications of a survey of the Mental Health Directors in all 51 state and federal prison systems on the extent of SIB by inmates, including incidence and prevalence, adverse consequences, and management. Thirty-nine of the state and federal correctional systems (77%) responded to the survey. Fewer than 2% of inmates per year engage in SIB, but in 29 85%) of systems these events occur at least weekly to more than once per day. The highest rates of occurrence of these behaviors are in maximum security and lock-down units, and most often involve inmates with Axis II disorders. Despite the seriousness of the problem, systems typically collect little, if any, data on self-injurious behaviors, and management approaches lack widespread consistency.

Objective: This study sought information about the prevalence, epidemiology, and management of self-injurious behavior by inmates in U.S. prison systems. Although self-injurious behavior has long been the source of significant challenges in correctional settings, limited research is available on this topic. Methods: Mental health directors in all 51 state and federal prison systems were invited to respond to a 30-item questionnaire available online or in hard copy. Univariate statistics were used to describe significant aspects of the national experience with self-injurious behavior, and bivariate statistics were used to examine relationships between variables. Results: Thirty-nine systems (77%) responded to the survey. Responses indicated that Conclusions: The survey responses indicated the disruptive effects of self-injurious behavior in the nation's prisons, a need for better epidemiologic monitoring and data on such behavior, and the importance of developing and widely using effective interventions. The high response rate and expressed interest in follow-up projects suggest that state and federal correctional mental health directors see a need for better information and management in this area. (Psychiatric Services 62:285-290, 2011).