Burnout and victimisation: impact of inmates' aggression towards prison guards

Introduction

Prison is typically considered as a dangerous setting partly because of promiscuity and violence, which leads to a whole series of suffering and frustration among prisoners. Due to their occupation, prison guards must ensure the safety of the inmates, their colleagues, as well as any other persons working in prison and in the prison setting. Thus, correctional guards are the “Bumper excitement” of prison violence and suffer from stressful and traumatic events. Indeed, inmates’ sufferings and frustration are firstly expressed towards them because they share daily relationships with inmates. In addition, correctional guards are faced with the high inmate suicide risk. One potential consequence of these chronic stressful situations is burnout. Burnout is described as a three-dimensional syndrome composed of emotional exhaustion, depersonalization and sense of lack of personal accomplishment. Burnout is a severe psychological suffering, which can lead to depression. It has been initially identified among persons who are working with patients. Nevertheless, research shows that burnout is not a psychopathology of work but of the relationship with others. In other terms, burnout seems to arise when people share stressful, chronic and violent relationships with someone else. Burnout doesn’t appear per se in any international classification of mental disorders: clinicians often use the diagnosis of adjustment disorder.

Purpose

Our aim is to assess the impact of victimization on burnout among guards in French prisons. Prison guards were chosen for two major reasons. First, the custodial role of correctional officers is typically described as a stressful occupation, sensitive to burnout. Second, prison is generally considered “dangerous”. Indeed, victimizations and aggressions frequently occur. Consequently, we hypothesize that burnout levels will be high for prison guards. We also hypothesize that the intensity of the victimizations (verbal, physical or armed aggression) will heighten burnout levels.

Material and methods

Two hundred and thirty-five prison guards were involved. Among these 235 correctional guards, there were 46 women and 188 men, ranging from 22 to 56 years old. Victimizations were very common: more than 87 % had experienced an aggression, whether verbally, physically or armed. They were asked to fill out the French form of the Maslach burnout Inventory (MBI). The MBI is a 22-item self-report measurement that assesses the three dimensions of burnout: emotional exhaustion, depersonalization and personal accomplishment. Items are rated on a 7-point scale ranging from 0 (“never”) to 6 (“every day”). We have statistically created a new global level of burnout with the three dimensions. It is called “burnout level”. We have assessed two sets of independent variables (VI): demographic VI (age, sex, tenure, level of studies) and correctional VI (penal status of prison, victimizations). Regarding our dependent variables, we have four levels which are (1) global burnout (GB), (2) emotional exhaustion (EE), (3) depersonalization (D), and (4) personal accomplishment (PA). For the purpose of our study, we carried out variance analyses (Anova) in order to compare the averages of our groups of subjects. Further to Anova, we chose the Bonferroni/Dunn post hoc test.

Results

The results indicate that demographic variables such as age, sex or level of studies have no significant effect on GB, EE, D and PA levels. Tenure has a significant effect on GB and D levels. Concerning correctional variables, results show that the penal status of prison has a significant effect on GB and EE. Prison guards working with inmates incarcerated for more than 5 years report higher GB and EE than their counterparts working with inmates not already convicted. Victimizations have a significant effect on GB, EE, D and PA levels. Prison guards with physical or armed aggressions report higher global GB, EE, D and PA levels than prison guards without aggressions. Furthermore, prison guards with physical or armed aggressions report higher global GB and D levels than prison guards with verbal aggressions. Two major points are highlighted by our study. First, characteristics of prison and inmates are related to burnout among prison guards. Second, victimizations lead to burnout.     

Perceptions of correctional officers about suicidal behavior among prisoners in Dubrava prison

The number of suicide cases in Dubrava prison in Kosovo has increased from year to year. This study is based on the survey with 273 correctional officers at Dubrava Prison, aged 20–64-years-old, with 2 to 25 years of job experience. The aim of this article is to show the perception of the correctional officers about the motives that push prisoners through the suicide act. The objective of this study is to express the bi-variate correlation with the Pearson coefficient between independent variables of stigma, losing hope, correctional environment, court decision with the dependent variable of suicide behavior. Results shows that exist a strong positive correlation between the number of cases motivated by the correctional environment and court decision. Also, the study presents data about the season and time in which suicide cases are more present according to the experience of correctional officers. Results shows suicide cases occur after midnight and in the early hours of the morning, and most of them in the first part of spring.     

Evaluation of the risk factors of suicide in patients treated for mental disorders. Review of the literature from 1978 to 1988

Research on suicide risk factors among psychiatric patients has developed considerably over the last 10 years. The methodological problems are numerous. Tentatives of global prediction have been unsuccessful in describing one complete and specific picture of the mentally ill suicide, whereas lawsuits against psychiatrists are frequent after patients' suicides. Through the analysis of 37 publications from 1978 to 1988 the authors review the main suicide risk factors identified among treated psychiatric patients.     

Treating PTSD Within the Context of Heightened Suicide Risk

Because posttraumatic stress disorder (PTSD) is one of the few psychological conditions that predict suicidal behavior among those who think about suicide, many patients with PTSD present clinically with elevated suicide risk. Expert consensus and practice guidelines recommend against trauma-focused treatments for patients with elevated suicide risk, however. Research aimed at understanding the common mechanisms that underlie the association of PTSD and suicide risk has led to several advances in the effective care of suicidal patients diagnosed with PTSD. Based on these results, various combinations and sequences of suicide-focused treatments, risk management procedures, and trauma-focused treatments are implicated.     

What role does race play in adolescent suicidal ideation?

Epidemiological data indicate that suicide rates have been decreasing among 15-19-year-olds in the United States; however, rates have been increasing among some minority groups. Research has identified numerous risk factors for adolescent suicide and suicide-related behaviors, but models testing these risk factors within different racial or ethnic groups are scarce. The current study tested a model of adolescent suicide ideation in a sample of 258 high school students, comparing the model fit across two racial groups. The model significantly fit the data for both groups indicating that the relationship between suicide exposure and current suicidal ideation is mediated by reasons for living and level of depressive symptoms. Ways in which the results improve our understanding of risk factors in diverse adolescents are discussed.     

Juvenile offender suicide: prevalence, risk factors, assessment, and crisis intervention protocols

Suicide is the leading cause of death in juvenile detention and correctional facilities. Moreover incarcerated juvenile offenders have an estimated suicide risk four times greater than adolescents in the general population. To address the problem of juvenile offender suicide, this article describes the extent of the problem and protocols for intervening with this high-risk population. Procedures for crisis intervention are recommended, and we delineate and discuss the step-by-step sequential Roberts' 7 stage crisis assessment and crisis intervention model. The article concludes with an examination of the extent to which suicide assessment and prevention protocols are currently being implemented in juvenile justice facilities. The implementation of suicide prevention programs has been shown to decrease risk of suicide in juvenile offenders; however, much work is still needed to encourage facilities to implement comprehensive assessment and prevention programs nationwide.     

Suicidal Ideation Among American Indian Youths

ABSTRACT

Epidemiological data indicate that suicide rates have been decreasing among 15–19-year-olds in the United States; however, rates have been increasing among some minority groups. Research has identified numerous risk factors for adolescent suicide and suicide-related behaviors, but models testing these risk factors within different racial or ethnic groups are scarce. The current study tested a model of adolescent suicide ideation in a sample of 258 high school students, comparing the model fit across two racial groups. The model significantly fit the data for both groups indicating that the relationship between suicide exposure and current suicidal ideation is mediated by reasons for living and level of depressive symptoms. Ways in which the results improve our understanding of risk factors in diverse adolescents are discussed.     

Suicide risk in adolescents with chronic illness: implications for primary care and specialty pediatric practice: a review

Suicide in adolescents is a global tragedy. Research‐identified correlates of suicide in youth include depression, academic failure, loss of friends, social isolation, and substance abuse, among others. This review focuses on the potential link between chronic illness in adolescents and increased suicide risk. Research suggests that chronic illness is a risk factor for depression in adolescents that may induce suicide ideation and attempts; however, this risk may be increased even more in young adulthood if the underlying causes of depression are not resolved. This risk needs to be considered against the research data noting an increase in suicide attempts and completions, in each decade of life from adolescence into adulthood. Although more research is clearly needed, it can be concluded that suicide risks are seen in adolescents with chronic illness and all of these young people should be screened for depression and other risk factors for suicide on a regular basis.     

Suicide risk in schizophrenia: learning from the past to change the future

Suicide is a major cause of death among patients with schizophrenia. Research indicates that at least 5–13% of schizophrenic patients die by suicide, and it is likely that the higher end of range is the most accurate estimate. There is almost total agreement that the schizophrenic patient who is more likely to commit suicide is young, male, white and never married, with good premorbid function, post-psychotic depression and a history of substance abuse and suicide attempts. Hopelessness, social isolation, hospitalization, deteriorating health after a high level of premorbid functioning, recent loss or rejection, limited external support, and family stress or instability are risk factors for suicide in patients with schizophrenia. Suicidal schizophrenics usually fear further mental deterioration, and they experience either excessive treatment dependence or loss of faith in treatment. Awareness of illness has been reported as a major issue among suicidal schizophrenic patients, yet some researchers argue that insight into the illness does not increase suicide risk. Protective factors play also an important role in assessing suicide risk and should also be carefully evaluated. The neurobiological perspective offers a new approach for understanding self-destructive behavior among patients with schizophrenia and may improve the accuracy of screening schizophrenics for suicide. Although, there is general consensus on the risk factors, accurate knowledge as well as early recognition of patients at risk is still lacking in everyday clinical practice. Better knowledge may help clinicians and caretakers to implement preventive measures. This review paper is the results of a joint effort between researchers in the field of suicide in schizophrenia. Each expert provided a brief essay on one specific aspect of the problem. This is the first attempt to present a consensus report as well as the development of a set of guidelines for reducing suicide risk among schizophenia patients.