This paper reports on a study that explored community psychiatric nurses' experiences of working with people who self-harm. Interpretative Phenomenological Analysis was used with eight experienced community psychiatric nurses who participated in semi-structured interviews. Established quality control procedures were utilized including audit of the analysis process and validating the results with participants. The participants described struggling to conceptualize self-harm behaviour and generally reported finding working with people who self-harm stressful particularly in terms of managing the emotional impact upon themselves and the boundaries of their professional responsibilities in relation to managing risk. The therapeutic relationship was viewed as crucial and a variety of coping methods to manage the impact of the work, which had largely developed through 'on the job', experience were described. The results highlight the potential difficulties faced by community staff and can be translated into clear recommendations for training and support.

Audit of mental health promotion in primary care Mental health promotion (MHP) is advocated as part of the National Service Framework for Mental Health1 and the stepped care approach to treatment in the NICE guidelines. Here, the authors present the findings of their study to investigate understanding and implementation of MHP in primary care in a London borough. Copyright © 2008 Wiley Interface Ltd