The function of food refusal in male prisons and custodial environments. A rapid evidence assessment (REA)

Purpose This rapid evidence assessment (REA) study aims to synthesise what is known about food refusal within male prison populations to aid a better understanding of why this occurs. By looking at the various functions of food refusal for this population, it is hoped that professionals can better support prisoners’ needs in this area. Design/methodology/approach A rapid review of available data within the published literature was completed. Searches were conducted on two databases (PsychInfo and MedLine), and a total of 328 articles were screened using a three-stage process. This resulted in 13 articles being identified for the final sample, which were reviewed and synthesised into themes by looking for commonalities. Findings Five themes were identified: “to protest”, “to achieve goals or demands”, “to manage interpersonal difficulties with prison/custodial staff”, “to end life” and “mental health and personality disorder”. The findings appear to suggest that food refusal in this context may be predominantly driven by a need to communicate or gain control. Practical implications To help prevent and cease food refusal, it will be beneficial for prison staff to use approaches that support prisoners feeling a sense of fairness, transparency, control and autonomy, as well as problem-solving skills and establishing a sense of purpose and motivation. Originality/value This REA confirmed there is a lack of good-quality research into the functions of food refusal among prisoners in the UK. Future research should involve contact with prisoners who have engaged in food refusal to understand motivations firsthand.