Harm reduction as a strategy for supporting people who self-harm on mental health wards: the views and experiences of practitioners

James, Karen; Samuels, Isaac; Moran, Paul; Stewart, Duncan

doi:10.1016/j.jad.2017.03.002

Cited by 32 publications

(66 citation statements)

References 19 publications

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“…Additionally, policies and guidelines in the clinical area need to adapt and greater collaboration is required from management and multidisciplinary team members as it has been identified that the use of harm reduction is difficult in the absence of clear clinical and legal guidance (James et al . ).…”

Section: Discussionmentioning

confidence: 97%

“…There is no established model of harm reduction in self‐harm (James et al . ), and interventions are wide‐ranging and can differ between clinical settings. Much attention is given to the contentious issue of the provision of clean instruments with which to harm oneself; however, other more commonly utilized methods of harm reduction include employing alternatives to cutting and education on ‘safe’ ways to self‐harm and appropriate self‐aftercare (Doyle et al .…”

Section: Discussionmentioning

confidence: 99%

“…These findings are in keeping with the results of the study by James et al . () who discovered that mental health practitioners who had implemented a harm reduction approach reported a positive outcome including a reduction in episodes and severity of self‐harm along with an apparent increase in empowerment of patients.…”

Section: Discussionmentioning

confidence: 99%

“…; Edwards & Hewitt ; James et al . ; Sullivan ). In addition, it has also been reported that mental health nurses may not feel skilled, comfortable, or empowered to discuss harm reduction techniques with patients (Pengelly et al .…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, the emotional response to supervising self‐harm and the psychological burden of working with the risk potentially associated with facilitated self‐harm may be very difficult for health professionals to reconcile with (James et al . ; Pickard & Pearce ).…”

Section: Discussionmentioning

confidence: 99%

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‘There is no progression in prevention’ – The experiences of mental health nurses working with repeated self‐harm

Murphy

Keogh

Doyle

2019

Int J Mental Health Nurs

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Caring for people who self‐harm is an everyday experience for mental health nurses and an important part of their role. How mental health nurses respond to and support those who self‐harm can have a significant impact on the outcomes for service users and their intentions to seek help in the future. Repeated self‐harm can be a particularly challenging phenomenon as it is often misunderstood and can have a negative impact on the therapeutic relationship. This qualitative descriptive study aims to explore how mental health nurses understand and work with repeated self‐harm. Nine nurses working in a range of mental health settings within one service participated in semi‐structured interviews which were analysed thematically. Findings are presented in two themes exploring participants’ perceptions and understanding of repeated self‐harm, and the process of learning to work with repeated self‐harm, and are reported in accordance with the consolidated criteria for reporting qualitative research guidelines (COREQ). Participants reported that nursing practice relating to repeated self‐harm remains largely focused on maintenance of safety and prevention of self‐harm despite the identification that this often does not work. It was accepted that there is sometimes a lack of understanding about the function of self‐harm; however, participants reported understanding increased following specific education about self‐harm. Participants also identified the potential for more empowering and recovery‐orientated responses, including the utilization of harm reduction approaches, to the care of those who repeatedly self‐harm.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

‘There is no progression in prevention’ – The experiences of mental health nurses working with repeated self‐harm

Murphy

Keogh

Doyle

2019

Int J Mental Health Nurs

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How do people conceptualize self‐harm recovery and what helps in adolescence, young and middle adulthood? A qualitative meta‐synthesis

Lewin,

Leamy,

Palmer

2023

J Clin Psychol

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ObjectiveSelf‐harm can be understood as any behavior individuals use to harm themselves, irrespective of motive. Evidence has extensively examined the epidemiology and function of self‐harm to the individual, but less is known about the subjective processes underpinning recovery. Such insights could inform therapeutic interventions to better support individuals. The present aim was to synthesize qualitative themes from eligible literature to identify how adolescents, young adults, and those in middle adulthood conceptualize self‐harm recovery and the factors impacting this process.MethodsEleven studies were identified from a systematic search of five electronic research databases: PsycINFO, Embase, Medline, Global Health, and CINAHL. Studies were critically appraised using an adapted Critical Appraisal Skills Program tool for qualitative research. A meta‐synthesis was conducted using reflexive thematic analysis to generate themes across the included studies.ResultsThemes depicted recovery as a multidimensional, nonlinear, and subjective process, characterized by a “push and pull” between states of (re‐)engagement and cessation/reduction. Transition between these states was influenced by intrapersonal and interpersonal factors which were embedded in a wider milieu of the meaning of self‐harm to the individual.ConclusionContemporary ideas of symptom eradication as the only marker of complete recovery may hinder individuals in the long‐term, presenting an obstacle both to quality of life and therapeutic progress. Movement away from self‐harm recovery as a uniform or singular phenomenon could enhance person‐centered care.

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Experiences of Unintentionally Severe Harm During Nonsuicidal Self‐Injury Among College Students

Muller

Buser

Farag

et al. 2020

J of College Counseling

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Nine participants were interviewed about their experiences with unintentionally severe injury during engagement in nonsuicidal self-injury. Using interpretative phenomenological analysis, we identified four common themes among participants: (a) explosive affect prior to unintentional injury, (b) loss of control during unintentional injury, (c) unfamiliar method, and (d) consequences of unintentional injury. Implications for research and practice are discussed.

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Harm reduction as a strategy for supporting people who self-harm on mental health wards: the views and experiences of practitioners

Cited by 32 publications

References 19 publications

‘There is no progression in prevention’ – The experiences of mental health nurses working with repeated self‐harm

‘There is no progression in prevention’ – The experiences of mental health nurses working with repeated self‐harm

How do people conceptualize self‐harm recovery and what helps in adolescence, young and middle adulthood? A qualitative meta‐synthesis

Experiences of Unintentionally Severe Harm During Nonsuicidal Self‐Injury Among College Students

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