title: Changes in mental health policy and their influence on self-injurious behaviours in the Israeli military prison system.
abstract: OBJECTIVE
  Self-injurious behaviours (SIBs) are widespread among prisoners and are sometimes classified as potentially calculated acts intended to control others. Access to a psychiatrist may be valued by imprisoned soldiers seeking immediate release from service. The main goal of the study was to assess the effects of a new mental health regulation in the Israel Defense Forces (IDF) prison system, which requires ordering an immediate interview with a psychiatrist for inmates performing SIBs.
  
  
  METHODS
  Frequency of SIBs in 2 military prisons was examined and compared for 11 months before and 10 months after the implementation of the regulation. Severity of injuries and rates of release from service were examined for 4 months.
  
  
  RESULTS
  The frequency of SIBs significantly increased after the implementation of the regulation in one prison, but not in the other. No effect was found for rate of release from service or for severity of injuries.
  
  
  CONCLUSIONS
  Increased accessibility to a psychiatrist for military prisoners may have resulted in increased motivation for inmates to perform SIBs. These effects are limited to the prison that serves a higher proportion of highly stressed soldiers.
authors.affiliation: Psychiatry B Department, Beer Yaakov Mental Health Center, Sackler School of Medicine, Tel Aviv University, Israel. iulian1@bezeqint.net
authors.forename: Iulian
authors.initials: I
authors.lastname: Iancu
authors.forename: Ehud
authors.initials: E
authors.lastname: Bodner
authors.forename: Amiram
authors.initials: A
authors.lastname: Sarel
authors.forename: Haim
authors.initials: H
authors.lastname: Einat
mesh_terms: D006291:Health Policy; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008605:Mental Health Services / Q000331:legislation & jurisprudence*; D008889:Military Personnel / Q000523:psychology* / Q000706:statistics & numerical data; D008890:Military Psychiatry; D009042:Motivation; D015995:Prevalence; D011330:Prisons / Q000706:statistics & numerical data*; D012054:Reinforcement, Psychology; D016728:Self-Injurious Behavior / Q000453:epidemiology* / Q000628:therapy*; D012922:Social Change