Abstract
International research has shown higher levels of childhood and adulthood trauma and considerably higher rates of Post-Traumatic Stress Disorder (PTSD) among women in prison compared with women in the community. A large body of research has established the detrimental impact of prison on the mental health and well-being of imprisoned people. In response to this, since 2015, women's prisons within His Majesty's Prison and Probation Service (HMPPS) have been working towards becoming trauma-informed and trauma-responsive with the delivery of the 'Becoming Trauma-Informed' (BTI) staff training for all staff working in women's prisons identified as a primary action to achieve this goal.At the outset of this PhD, there had been no research into the BTI training. Research exploring the feasibility of creating trauma-informed and responsive whole services, and of the impact of providing trauma-informed care (TIC) at the service or system level was limited. Therefore, whilst the prevalence of trauma in the lives of women in prison provides evidence of the need for prisons to be trauma-informed, there was a lack of evidence that prisons could become trauma-informed and responsive whole systems, as well as a lack of understanding of what would be required organisationally to achieve this goal.
To address this question, this thesis incorporates three qualitative studies undertaken with 51 individuals living in three women’s prisons in England, and 35 individuals working within two of the same three prisons. Reflexive inductive thematic analysis was used to analyse the data collected via semi-structured interviews, with researcher reflexivity central to the process. Study 1 asked the question of how the trauma histories of individuals in prison affected their experience of imprisonment. Study 2 explored the perceptions of individuals living in women's prisons of the barriers and enablers to TIC, including their perceptions of the way the BTI training had impacted the attitudes and behaviour of staff. Study 3 focused on the prison officers’ experiences of the barriers and enablers to TIC, as well as how they perceived the impact of the BTI training on the care provided to women in prison.
Thematic synthesis was used to develop an overview from the multiple perspectives across the three studies. The meta-findings were conceptualised at the individual, the relational/interpersonal, and the organisational/system level, and are represented as a ‘Holistic Ecological Model of the Barriers and Enablers of TIC in Prison: A Model Derived from Lived Experience’. There were a multitude of ways in which individuals experienced their imprisonment as (re)traumatising, which exacerbated their preexisting psychological and emotional difficulties. Most opportunities for TIC were at the interpersonal level, requiring compassionate and skilled staff, however, the power dynamics between staff and individuals in prison impacted the provision of TIC. Time and resource pressures and a lack of organisational support for staff also undermined TIC. Overall, the findings demonstrated the fragility of TIC within a system which generated trauma.
Before women’s prisons can become trauma-informed and responsive whole systems the damaging impacts of the prison environment and system must be eradicated. This creates a substantial challenge for HMPPS and indicates that moving towards and maintaining trauma-informed and responsive women’s prisons is a long-term aspiration. However, this research identifies recommendations for changes to relational practices, as well as to organisational systems, policies, and processes which could improve the ability of HMPPS to deliver TIC within women’s prisons. Co-production with individuals with experience of living and working in prisons is essential.
| Date of Award | 1 Oct 2024 |
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| Original language | English |
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| Supervisor | Deirdre MacManus (Supervisor), Laura Palmer (Supervisor) & Rachael Gribble (Supervisor) |