• This is the second annual report on all recorded episodes of self-harm by individuals in the custody of the Irish Prison Service. The report provides data from all prisons in the Republic of Ireland in 2018 arising from the Self-Harm Assessment and Data Analysis (SADA) Project.

 Main findings:

• Between 01 January and 31 December 2018, there were 263 episodes of self-harm recorded in Irish Prisons, involving 147 individuals. There were 223 episodes of self-harm by 138 individuals in 2017. Thus, the number of self-harm episodes was 18% higher in 2018 than in 2017 and the number of persons involved increased by 7%. The overall prison population also increased by 7% between 2017 (n=3,427) and 2018 (n=3,690). Therefore, the annual person-based rate of self-harm in 2018, at 4.0 per 100 prisoners, was identical to the rate recorded in 2017. Thus, an episode of self-harm was recorded for 4% of the prison population.
• The majority of prisoners who engaged in self-harm were male (n=121; 82.3%) but taking into account the male prison population, their rate of self-harm was 3.4 per 100. Twenty-six female prisoners engaged in self-harm in 2018 equating to a rate of 19.3 per 100, which is 5.7 times higher than the rate among male prisoners.
• The rate of self-harm was higher among prisoners on remand than those sentenced (5.0 versus 3.7 per 100) though by a smaller margin than reported for 2017 when the rate of self-harm among prisoners on remand was 7.4 per 100 and the rate among sentenced prisoners was 3.1 per 100.
• The rate of self-harm was highest among prisoners aged 18-29 years. The rate of self-harm among prisoners in this age group was 40% higher than in 2017 (7.4 versus 5.3 per 100). Across all age groups, the rate of self-harm was higher among female prisoners.
• Almost half of all self-harm incidents (44%) occurred between 2pm and 8pm. Most episodes (60%) occurred while prisoners were unlocked from cells.
• One-third (32.7%) of individuals engaged in self-harm more than once during the calendar year. This was more pronounced for female prisoners – 29.8% of male prisoners repeated self-harm (36 out of 121 individuals) compared with 46.2% of female prisoners (12 out of 26 individuals). Two individuals engaged in self-harm more than ten times in 2018.
• The most common method of self-harm recorded was self-cutting or scratching, present in 69% of all episodes. The other common method of self-harm was attempted hanging, involved in 20% of episodes.
• In line with 2017 figures, three-quarters (73%) of self-harm episodes involved prisoners in single cell accommodation. Considering the overall prison population, 51.9% were accommodated in single cells in 2018. Forty-four percent of prisoners who engaged in self-harm were in general population accommodation and a further 37% were on protection (including Rule 62 and 63) at the time of the self-harm act.
• For more than one quarter (27%) of episodes, no medical treatment was required. Over half (59%) required minimal intervention or local wound management in the prison and one in eight (12%) required hospital outpatient or accident and emergency department treatment. Self-harm episodes by male prisoners were associated with increased severity – 87.4% of male prisoners who self-harmed required some medical treatment compared with 30.8% of female prisoners.
• Over two-thirds (70%) of self-harm episodes were recorded as having no / low degree of suicidal intent. Seventeen per cent of episodes were recorded as having medium intent and approximately one in eight (13%) were deemed to have a high degree of suicidal intent.
• There was a range of contributory factors associated with the episodes of self-harm recorded, relating to environmental, relational, procedural, medical and mental health factors. The majority (45.6%) of factors related to mental health issues, 32.7% to environmental issues and 22.1% to relational issues.