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Adjudications and self-harm in prisons during COVID-19: three-year longitudinal analysis of the Offender Personality Disorder Pathway in England and Wales

Steven M. Gillespie Orcid Logo, Andrew Jones, Laura Broome Orcid Logo, Matthew J. Tonkin, Aisling O’Meara Orcid Logo, Carine Lewis, Rachael Dagnall, Shadd Maruna, Jason Davies Orcid Logo

BJPsych Open, Volume: 11, Issue: 6, Start page: e267

Swansea University Authors: Laura Broome Orcid Logo, Jason Davies Orcid Logo

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DOI (Published version): 10.1192/bjo.2025.10883

Abstract

Background: The effects of pandemic-related restrictions on people in prisons who tend to have multiple complex health needs are not well understood. Aims: We aimed to measure changes in adjudications and self-harm among people in prisons before and during the pandemic. Method: We examined effects o...

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Published in: BJPsych Open
ISSN: 2056-4724
Published: Cambridge University Press (CUP) 2025
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spelling 2025-12-01T13:59:30.4813973 v2 70448 2025-09-22 Adjudications and self-harm in prisons during COVID-19: three-year longitudinal analysis of the Offender Personality Disorder Pathway in England and Wales 5109c18f411b3e26761e3f300f2e5f4f 0000-0002-8405-254X Laura Broome Laura Broome true false b7dab4136f5c9c0614cda9bf2d5910b0 0000-0002-1694-5370 Jason Davies Jason Davies true false 2025-09-22 PSYS Background: The effects of pandemic-related restrictions on people in prisons who tend to have multiple complex health needs are not well understood. Aims: We aimed to measure changes in adjudications and self-harm among people in prisons before and during the pandemic. Method: We examined effects of time and demographic characteristics on odds and counts of adjudications and self-harm over a three-year period, starting one year before the COVID-19 pandemic, in 861 individuals from 21 Offender Personality Disorder Pathway prison sites. Results: The odds of adjudicating were lower in people of older age (odds ratio 0.98 (95% CI: 0.96–0.99)), and during COVID-19 year one (odds ratio 0.37 (95% CI: 0.23–0.60)) and year two (odds ratio 0.40 (95% CI: 0.25–0.65)) compared to pre-COVID-19. Being of White ethnicity was associated with increased odds (odds ratio 4.42 (95% CI: 2.06–9.47)) and being older was associated with reduced odds (odds ratio 0.97 (95% CI: 0.95–0.99)) of self-harm. The odds of self-harm were significantly reduced during COVID-19 year two (odds ratio 0.45 (95% CI: 0.26–0.78)), but not during COVID-19 year one (odds ratio 0.68 (95% CI: 0.40–1.14)), compared with the 12 months before COVID-19. Conclusions: Although adjudications and self-harm were generally lower during the pandemic, younger people showed increased odds of adjudications and self-harm compared with older people, while White people showed increased odds of self-harm compared with people of the global majority. Our findings highlight the importance of considering potential health inequities and environmental effects of lockdowns for people in prisons. Journal Article BJPsych Open 11 6 e267 Cambridge University Press (CUP) 2056-4724 Conduct disorders, social functioning, personality disorders, psychiatry and law, prison 4 11 2025 2025-11-04 10.1192/bjo.2025.10883 COLLEGE NANME Psychology School COLLEGE CODE PSYS Swansea University SU Library paid the OA fee (TA Institutional Deal) This work was supported by the Economic and Social Research Council (grant number ES/W000156/1). 2025-12-01T13:59:30.4813973 2025-09-22T12:12:47.7670142 Faculty of Medicine, Health and Life Sciences School of Psychology Steven M. Gillespie 0000-0001-7789-5381 1 Andrew Jones 2 Laura Broome 0000-0002-8405-254X 3 Matthew J. Tonkin 4 Aisling O’Meara 0000-0001-5129-7471 5 Carine Lewis 6 Rachael Dagnall 7 Shadd Maruna 8 Jason Davies 0000-0002-1694-5370 9 70448__35721__95404db084794b63b3ab374c5501c49d.pdf 70448.VOR.pdf 2025-12-01T13:57:47.9595348 Output 369012 application/pdf Version of Record true © The Author(s), 2025. Published by Cambridge University Press on behalf of Royal College of Psychiatrists. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence. true eng https://creativecommons.org/licenses/by/4.0/
title Adjudications and self-harm in prisons during COVID-19: three-year longitudinal analysis of the Offender Personality Disorder Pathway in England and Wales
spellingShingle Adjudications and self-harm in prisons during COVID-19: three-year longitudinal analysis of the Offender Personality Disorder Pathway in England and Wales
Laura Broome
Jason Davies
title_short Adjudications and self-harm in prisons during COVID-19: three-year longitudinal analysis of the Offender Personality Disorder Pathway in England and Wales
title_full Adjudications and self-harm in prisons during COVID-19: three-year longitudinal analysis of the Offender Personality Disorder Pathway in England and Wales
title_fullStr Adjudications and self-harm in prisons during COVID-19: three-year longitudinal analysis of the Offender Personality Disorder Pathway in England and Wales
title_full_unstemmed Adjudications and self-harm in prisons during COVID-19: three-year longitudinal analysis of the Offender Personality Disorder Pathway in England and Wales
title_sort Adjudications and self-harm in prisons during COVID-19: three-year longitudinal analysis of the Offender Personality Disorder Pathway in England and Wales
author_id_str_mv 5109c18f411b3e26761e3f300f2e5f4f
b7dab4136f5c9c0614cda9bf2d5910b0
author_id_fullname_str_mv 5109c18f411b3e26761e3f300f2e5f4f_***_Laura Broome
b7dab4136f5c9c0614cda9bf2d5910b0_***_Jason Davies
author Laura Broome
Jason Davies
author2 Steven M. Gillespie
Andrew Jones
Laura Broome
Matthew J. Tonkin
Aisling O’Meara
Carine Lewis
Rachael Dagnall
Shadd Maruna
Jason Davies
format Journal article
container_title BJPsych Open
container_volume 11
container_issue 6
container_start_page e267
publishDate 2025
institution Swansea University
issn 2056-4724
doi_str_mv 10.1192/bjo.2025.10883
publisher Cambridge University Press (CUP)
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str School of Psychology{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}School of Psychology
document_store_str 1
active_str 0
description Background: The effects of pandemic-related restrictions on people in prisons who tend to have multiple complex health needs are not well understood. Aims: We aimed to measure changes in adjudications and self-harm among people in prisons before and during the pandemic. Method: We examined effects of time and demographic characteristics on odds and counts of adjudications and self-harm over a three-year period, starting one year before the COVID-19 pandemic, in 861 individuals from 21 Offender Personality Disorder Pathway prison sites. Results: The odds of adjudicating were lower in people of older age (odds ratio 0.98 (95% CI: 0.96–0.99)), and during COVID-19 year one (odds ratio 0.37 (95% CI: 0.23–0.60)) and year two (odds ratio 0.40 (95% CI: 0.25–0.65)) compared to pre-COVID-19. Being of White ethnicity was associated with increased odds (odds ratio 4.42 (95% CI: 2.06–9.47)) and being older was associated with reduced odds (odds ratio 0.97 (95% CI: 0.95–0.99)) of self-harm. The odds of self-harm were significantly reduced during COVID-19 year two (odds ratio 0.45 (95% CI: 0.26–0.78)), but not during COVID-19 year one (odds ratio 0.68 (95% CI: 0.40–1.14)), compared with the 12 months before COVID-19. Conclusions: Although adjudications and self-harm were generally lower during the pandemic, younger people showed increased odds of adjudications and self-harm compared with older people, while White people showed increased odds of self-harm compared with people of the global majority. Our findings highlight the importance of considering potential health inequities and environmental effects of lockdowns for people in prisons.
published_date 2025-11-04T12:39:46Z
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