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

Gillespie, SM ORCID: 0000-0001-7789-5381, Jones, A, Broome, LJ, Tonkin, MJ, O’Meara, A ORCID: 0000-0001-5129-7471, Lewis, C, Dagnall, R, Maruna, S ORCID: 0000-0002-4978-7073 and Davies, J ORCID: 0000-0002-1694-5370 (2025) Adjudications and self-harm in prisons during COVID-19: three-year longitudinal analysis of the Offender Personality Disorder Pathway in England and Wales Bjpsych Open, 11 (6). e267-. ISSN 2056-4724, 2056-4724

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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 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.

Item Type:	Article
Uncontrolled Keywords:	Conduct disorders, social functioning, personality disorders, psychiatry and law, prison
Divisions:	Faculty of Health & Life Sciences Faculty of Health & Life Sciences > Inst. Population Health Faculty of Health & Life Sciences > Inst. Population Health > Primary Care & Mental Health Faculty of Health & Life Sciences > Inst. Population Health > Inst. Population Health (T&R Staff)
Depositing User:	Symplectic Admin
Date Deposited:	04 Nov 2025 14:09
Last Modified:	28 Feb 2026 01:08
DOI:	10.1192/bjo.2025.10883
Open Access URL:	https://doi.org/10.1192/bjo.2025.10883
Related Websites:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3195202
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