Insiders' views of their role: toward their training.

• Author: Boothby, Margorit Rita Krespi

Introduction

Prisoners' mental health needs are varied and complex. Studies have shown that, for example, in England and Wales around 90% of the prison population has some kind of psychological disorder, 72% of prisoners have at least one type of psychological disorder, and around 15% of prisoners have four or five co-existing psychological disorders (Fazel and Danesh 2002; Shaw, Baker, Hunt, Moloney, and Appleby 2004). The rate of suicide in the UK prison population is also high: 92% of all suicides in prison are carried out by male prisoners (Shaw et al. 2004). Around 50% of all prison suicides occur within the first week of being in custody (Shaw et al. 2004). Self-harm that has the potential of being fatal is also a big challenge for prison staff. For example, in the United States, the rate of self-harm has been estimated to be 52.9% among prisoners who were diagnosed as mentally ill (Gray, Hill, McGleish, Timmons, MacCulloch, and Snowden 2003). Overall, the rates of psychological disorders and of suicide and self-harm in prison are higher than those in the community (Fremouw, de Perczel, and Ellis 1990; Howells, Halls, and Day 1999; Singleton, Meltzer, Gatward, Cold, and Deasy 1988).

In the prison population, the challenges of the prison environment can deteriorate pre-existing psychological problems and increase existing risk of suicide (Liebling 1994). On the other hand, these problems can develop as a result of the effects of being in custody (Edwards and Potter 2004).

The prison service has introduced a number of peer support schemes for prisoners, which are run by prisoners to contribute to suicide and self-harm prevention and a safer prison environment by helping to create healthy relationships among prisoners and between prisoners and prison staff (Devilly, Sorbello, Eccleston, and Ward 2005). These include the Listeners Scheme and the Insiders Scheme. The Listeners Scheme, supported by the Samaritans charity, consists of volunteers called Listeners, who aim to provide confidential emotional support to other prisoners throughout their incarceration. The Listeners operate on the basis of the rules of confidentiality. The Insiders Scheme consists of volunteers called Insiders, who aim to provide basic information, reassurance, and practical support (although not emotional support) to prisoners who are new to prison system. This scheme supports the prisoners shortly after their arrival in prison and operates only during the early days of incarceration. Unlike the Listeners, Insiders do not operate on the basis of the rules of confidentiality. Employment in the prison follows a system of categorization by bands, each type of band bringing different privileges. One type of band, the red band, is assigned the highest level of privileges. Insiders and Listeners operate within the red band along with others with red band roles.

Within the context of offending behaviour, the Differential Association Theory (Sutherland and Cressey 1960), the Cognitive Dissonance Theory (Festinger 1957), and the construct of social support can help to explain how the peer programs work.

Differential Association Theory argues that, through interacting with people who can teach the skills and techniques involved in offending, one can learn offending behaviour (Milburn 1995; Turner and Shepherd 1999). Similarly, offenders acting as peer supporters can also help other offenders change their offending behaviour and lifestyles (Turner and Shepherd 1999). Cognitive Dissonance Theory postulates that, when prisoners assume the role of peer supporters, they change their own beliefs and values and, in turn, contribute to their own rehabilitation (Keller 1993; Maruna 2001). Therefore, these programs acknowledge that prisoners do not have to be passive recipients of rehabilitation and consider them as important resources within the prison system to contribute to prisoners' rehabilitation (Cressey 1965; Kerish 1975).

There is no consensus with regards to the definition of social support. There are several ways of categorizing the definitions of social support. One way is to pay attention to the qualitative and quantitative aspects of it (see also Elal and Krespi 1999). An example of the qualitative aspect of social support is perceived social support, which refers to the individual's perception of the quality of social support activities (House 1981; see also Elal and Krespi 1999). On the other hand, an example of the quantitative aspect of social support is size of social network, which refers to the number of interpersonal ties (Nuckolls, Cassel, and Kaplan 1972; see also Elal and Krespi 1999). Other ways of categorizing the definitions of social support include whether social support is formal or informal and whether it is external or internal. Social support is formal when its source has an official status such as the criminal justice system or the health care profession, whereas it is informal when it is provided by someone who is one of the recipient's social connections (Cullen 1994). Internal social support refers to both informal and formal support that originates from inside an organization, such as from the prison establishment. External social support refers to both informal and formal support that originates from outside an organization, such as from the family.

Research has shown that external informal support such as family support can strengthen prisoners' family ties (Howser, Grossman, and MacDonald 1983; Howser and MacDonald 1982). In terms of rule violations in the prison, the findings have been mixed. Some studies have shown that family support helps reduce rule violations (Gordon and McConnell 1999). On the other hand, Jiang and Winfree (2006), in a national sample of prisoners, found that prisoners who perceive social support may or may not have lower rule-violation rates compared to prisoners who do not perceive social support. They found that, although telephone calls are related to lower rule violation, other aspects of social support, including mail, visitation, and both formal and informal support from prison, do not influence rule-violation rates.

An example of external formal support within the context of offenders can be the initiative called Circles of Support and Accountability (COSA). This is a model of support for sexual offenders formalized in 1996 (Mennonite Central Committee of Ontario 1996) and established in Canada, in many states of the United States, and in the Thames Valley, UK for those individuals who are released from prison without a formal process of care and support (Wilson, McWhinnie, Picheca, Prinzo, and Cortoni 2007). In Canada, COSA is run by people in the community and supported by professionals, whereas in the United Kingdom, it is run by professionals and supported by people in the community (Wilson et al. 2007). COSA essentially aims to reduce the risk of future sexual crimes by engaging community volunteers to help ex-offenders integrate into the community and lead productive lives through the provision of support and advocacy (Correctional Service of Canada 2002; Wilson et al. 2007).

Research has shown that offenders who took part in COSA had lower rates of any type of reoffending and higher harm-reduction behaviours than did the offenders who did not participate in COSA (Wilson, Picheca, and Prinzo 2005). The offenders who participated in COSA committed fewer sexual and violent and general offences than those who did not (Wilson et al. 2005).

Within the context of offenders, an example of internal formal support can be attendance at a prison education program. Research has shown that this can improve self-esteem and ability to deal with the prison environment and increase the quality of daily prison life (Ryan and McCabe 1994; Fagan 1989).

Peer-led programs can be also examples of internal formal support. Research has shown that peer-led programs are beneficial not only for the prisoners taking part in them but also for the peer educators themselves. For example, some studies have reported that schemes other than the Listeners and Insiders Schemes increase peer educators' insight into their own lives and empower them to change their offending behaviour and lifestyles (Keller 1993; Kerish 1975; Maheady 1998; Maruna 2001; Milburn 1995; Parkin and McKeganey 2000; Turner and Shepherd 1999). Preliminary reports on the effectiveness of the Listeners Scheme suggest that this helps toward reducing self-harm and improving communication and relationships between staff members and prisoners (Barker 2000). Similar reports on the Insiders Scheme suggest that it has a positive impact on prisoners' early experience of custody and that the Insiders themselves gain personal satisfaction from their roles (Safer Custody Group 2003).

Attempts to explain the effects of social support on well-being have focused on two models, including Buffering Model and Main Effect Model. The Buffering Model postulates that social support has greater positive effect under high stress than under low stress and therefore, when social support is high, individuals will less likely develop psychological problems. This is because, under high stress, people will be more inclined to request and to respond to social support and others will be more inclined to offer social support (Alloway and Bebbington 1987). It has been postulated that social support moderates the relationship between stress and psychological problems by preventing a negative appraisal of a life event (i.e., it helps to redefine the threat posed by a life event and/or maximizes the person's ability to cope with stress) (Cohen and Wills 1985). On the other hand, the Main Effect Model postulates that social support has a generalized beneficial effect on well-being and has an equally positive effect on this under both high and low stress because social support tends to provide positive affect, a sense of predictability and self-worth (Cohen and...