This paper aims to reflect on the function of food refusals in prisons. Previous rapid evidence assessment (Adlam and Powell, 2023) has indicated that literature has lacked robustness, and includes just one study based in the UK which is outdated. The paper also considers the role of mental health and how it may link to prisoners’ refusing food.
This study used a qualitative descriptive design in which 16 safety case reviews were analysed using thematic analysis (Braun and Clarke, 2006). The themes generated were subjected to an inter-rater reliability exercise for which a registered forensic psychologist was recruited.
Thematic analysis of the data resulted in four overarching themes: psychological state, coping, achieving a means to an end, and to end life. Psychological state included sub themes of mental health, cognitive rigidity and personality disorder. Achieving a means to an end included sub themes of protesting and achieving a goal.
The safety case review (SCR) is a standard psychology safety consultancy product in HMPPS which involves prisons making referrals to local psychology teams to complete them on specific prisoners. Given the wealth of information revealed whilst undertaking this research, it would be of beneficial for prisons to consider referring more food refusal cases for an SCR. Information from the case formulation process will continue to offer insights as to the prevalence and function of the behaviour in prisons over time. This study highlighted that future research may also consider the links between indeterminate sentence prisoners and food refusal as well as the links between personality disorder and food refusal.
There is limited research on food refusal in prisons in the UK, and hence this study makes an important contribution to developing the evidence base. The majority of these studies have occurred in other countries and lack robustness as well as being outdated.
