Abstract

Self-harm is a complex problem that affects millions of people around the world. It occupies a strategic position in suicide prevention of many countries and those who repeat self-harm may eventually die by suicide, a global health concern.
Despite much research conducted about self-harm in children and young people, very little research has been conducted with adults who self-harm, and their perspectives remain under-researched. This qualitative research focused on the views of adult mental health patients with the lived experience of self-harm to explore and understand their perspectives on self-harm and resilience.
This research has two sections: a systematic literature review and qualitative research. Systematic search of main electronic databases (PsychINFO, CINAHL, MEDLINE and PsychARTICLES) identified twelve articles for meta-synthesis. Four concepts emerged: social connection and belongingness, socio-economic factors, psycho-social factors and religion and cultural belongingness. All have been found to be associated with self-harm in adult mental health patients.
For the qualitative research, adult mental health patients [N=6; Mean age=40] were recruited from non-NHS and NHS sites. Data was obtained using semi-structured one-to-one telephone interviews that covered participants’ strategies to prevent or minimise self-harm: what helps them stop or reduce how often they self-harm or the severity of their self-harm, and which one they perceive as the most effective. The recorded interviews were transcribed verbatim and analysed using Interpretative Phenomenological Analysis (IPA).
Seven key themes were identified from the analysis. These were: (1) thinking of the consequences, (2) responding to stressful life events, (3) relationship with family and others, (4) connecting with others with the lived experience of self-harm, (5) understanding my illness and resilience journey, (6) seeking professional support and (7) using coping strategies and skills.
The findings revealed that resilience to self-harm is a non-linear process that involves the interplay of many factors, which may be contextual, the clinical implication of which warrants a holistic assessment and a person-centred approach in planning interventions. Therefore, collaborative working of multi-agency professionals with the adult with the lived experience of self-harm is crucial to support self-harm prevention and management. Strengths and limitations of the study and areas of future research are discussed, then the researcher’s reflective journey, detailing personal experiences and challenges. Following this, is the conclusion to the thesis.