Setting up the PROSPECT trial in prison
Written by Iniyah Sulaman and George Lofthouse, Research Assistant Psychologists, PROSPECT project
This blog offers some recent reflections from Iniyah Sulaman and George Lofthouse who work as Research Assistant Psychologists at the Suicide Risk and Safety Research Unit within Greater Manchester Mental Health NHS Foundation Trust. Iniyah and George are part of the PROSPECT research team that is seeking to evaluate a new psychological intervention for suicidal prisoners.
Working for PROSPECT has been a completely new challenge for us both. Finding your feet within a prison, whilst setting up the PROSPECT project has taught us an awful lot. We thought we would take the time share some of our learnings.
Introductions and cultivating staff relationships
There’s a sincere sense of community within the two Northwest prisons that we’re working with – a community that PROSPECT aims to be a part of. During set-up we aimed to make ourselves known and our goals understood. We quickly learnt that it was best to do in person rather than over the phone or email. We undoubtedly found that regular face to face interactions carried more weight and handing out PROSPECT branded stationary to staff definitely helped too.
PROSPECT branded stationary
As our office space is in the healthcare unit of the prison, it was essential for us to integrate ourselves within the wider healthcare team. This involved attending meetings where we informally introduced ourselves and the project. As well as this, we delivered a more detailed presentation outlining the trial which was met with enthusiasm. It’s important to us that members of the healthcare team feel involved in the project. By holding frequent discussions, we always considered the opinions of the healthcare staff who helped direct our attention towards those they believed needed immediate extra support. From this, it is clear that PROSPECT and healthcare work very well collaboratively.
Getting to know the prison
Integrating yourself and your service into any establishment has the potential to be difficult… however doing so within prisons, which each hold over 800 prisoners, is something that takes time and a fair amount of note taking. The nature of a prison is, for obvious reasons, extremely risk orientated. A large part of enabling PROSPECT to function within the host prisons was (and is) getting to grips with the routine of the establishments. When are the men unlocked (or free to navigate the wing), when are protected times (such as mealtimes), when are private rooms available to utilise, when are the staff training days (we swiftly learned that these days do not align with any prisoner contact). Learning about the regime and local processes such as these paralleled our ability to work autonomously. However, one size does not fit all, as each wing has their own way of functioning and their own structure. Learning about these processes and daily routines (by taking one wing at a time) is a must when aiming to work symbiotically within the prison services.
Despite this advice, learning all the processes cannot prepare you for how unpredictable and everchanging a prison can be. Eight wings, housing men with a variety of needs, personalities, challenges and risk factors creates an environment which we must flow with. Being prepared for the day ahead is always useful, however we swiftly noticed that Plan A, will soon become Plan B, then Plan C and so on. Often, having a detailed schedule of which participants we will meet and at what times isn’t realistic. It is crucial not to become disheartened when plans don’t materialise as other opportunities will most definitely arise.
Getting the balance right
Once the green light for recruitment was given, it became apparent that the way we approach and work with our participants is vital. Whilst working within a prison, steps must be taken to ensure that we are keeping ourselves safe whilst creating an environment that empowers participants to be truthful and open about their experiences of self-harm and suicide. Placing too much emphasis on risk and boundaries would surely abate the trusting relationship between us and our participant (potentially causing the participant unwanted negative affect and having adverse repercussions on the PROSPECT trial). Whereas disregarding all risk information and awareness of the person sat before us would be careless, even dangerous, and work against good research governance. Nurturing this balance will be different for each prisoner we engage with. The importance of this equilibrium will remain an integral responsibility in maintaining the welfare of our participants and ourselves whilst collating valid data for the PROSPECT trial.
About Iniyah Sulaman:
Iniyah is a full time Research Assistant Psychologist working for Greater Manchester Mental Health NHS Foundation Trust at the Suicide Risk and Safety Research Unit on the PROSPECT project. She has previously worked as a Research Assistant on an NIHR funded trial and as a mental health support worker.
Iniyah attended the University of Manchester to complete her undergraduate degree in psychology and her postgraduate degree in clinical and health psychology. So far, Iniyah’s work on PROSPECT has involved project set-up in the prison and starting the recruitment phase of the trial.
About George Lofthouse:
George is a full time Research Assistant Psychologist working for Greater Manchester Mental Health NHS Foundation Trust at the Suicide Risk and Safety Research Unit on the PROSPECT trial. He has worked as an Assistant Psychologist within Medium Secure Services, a Psychiatric Intensive Care Unit and Liverpool Heart and Chest Hospital.
George attended Leeds Beckett University to complete his undergraduate degree and Manchester Metropolitan University for his postgraduate degree, both of which were in psychology. George’s role within the PROSPECT team is primarily to approach and recruit participants and complete initial and follow up assessments.