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National and state suicide prevention frameworks require multiple approaches across three levels (primary, secondary and tertiary) in order to be effective. The three levels are:
Primary prevention - strategies which aim to create a physical and social environment in the prison that limits stress on prisoners and staff. This includes comprehensive screening/ induction / orientation processes to reduce stressors on prisoners upon admission to custody. Additional preventative measures include victim services for prisoners who may be victims of crimes or assault, anti-bullying policies to reduce or prevent bullying between prisoners, and the provision of structure, purpose and engagement through meaningful employment, programs, and education. Specialist training and support services for staff working with at risk inmates also contributes to primary prevention by providing a healthy well-informed staff with the skills and resources needed to manage at risk inmates.
Secondary prevention - includes strategies that aim to support inmates identified as at higher risk of suicide or self harm. Policies and procedures for Safe Custody, and Reception, Screening, Induction and The Risk Intervention Team (RIT) Protocol apply at this level.
Tertiary prevention - includes intensive strategies which are aimed directly at individuals who are identified as at risk of self-harm or suicide. Increased monitoring, the provision of psychological intervention, and / or placement in a safer environment including referral to a specialist unit such as Acute Crisis Management Unit or Mum Shirl Unit are tertiary prevention strategies. Additional tertiary prevention responses to reduce chronic risk of self-harm include focussed case management and progression planning Since 1998, Corrective Services has had an 'at risk' offenders program to reduce suicide, self harm and relapse of deliberate self harm among offenders in custody, upon release from custody and on community supervised orders. This involves a coordinated range of strategies, processes, units and teams that also collaborate with specialist mental health services in the community. As part of this process, Corrective Services uses specialist mental health professionals, such as psychologists, who work with Justice Health nurses and psychiatrists to identify and treat those at risk of deliberate self harm and/or who are mentally ill. Inmates identified as being at risk have access to specialist units and teams such as Long Bay Hospital, Mental Health Screening Units (one male, one female) and Acute Crisis Management Units (two male) and Mum Shirl Unit (female).