‘In two minds’ – socially motivated self-harm is perceived as less serious than internally motivated: A qualitative study of youth justice staff

Abstract

Community-based young offenders are at high risk of self-harm and unlikely to be in contact with mental health services. Semi-structured interviews with community youth justice staff and a content analysis of 50 records of self-harm not only revealed staff concerns about the impact of stigma on disclosure and service use, but also found dismissive attitudes towards socially motivated self-harm, which was equated with lower suicide risk and less emotional distress. Efforts to improve identification of self-harm will need to address the perceived - and false - distinction between 'genuine' and socially motivated self-harm.

Reasons for Non-Suicidal Self-Harm in Adult Male Offenders With and Without Borderline Personality Traits

“…In further support of this, there is some evidence that interpersonally motivated selfharm is not perceived to be a 'genuine' reason, and nor does it represent psychological distress or a risk of suicide (Knowles et al, 2013;Kenning et al, 2010;Short, Cooper, Shaw, Kenning, Abel & Chew-Graham, 2009). This is in spite of evidence that many offenders who self-report perceived manipulative functions such as 'to obtain a transfer', are simultaneously high in suicidal intent (Dear, Thomson & Hills, 2000).…”

“…These findings, along with the preference for intrapersonal reasons, are a challenge to prison staff who overestimate the interpersonally motivated reasons for self-harm (e.g., Kenning et al, 2010;Knowles et al, 2013). However, although less frequently endorsed by offenders, interpersonal reasons for self-harm are equally as present in offenders as they are in student populations (e.g., Klonsky & Glenn, 2009).…”

“…Nonetheless, a more balanced view of intra-and interpersonal functions is necessary, not least because: a) many individuals endorse multiple intra-and interpersonal functions simultaneously (Klonsky, 2009); and b) interpersonal functions should be acknowledged and understood. The latter is important because staff working with offenders often overestimate interpersonal functions such as "to gain attention", and perceive these to be manipulative and controllable reasons for self-harm (Pannell, Howells, & Day, 2003;Kenning et al, 2010;Knowles et al, 2013). Thus, it seems that interpersonal motivated self-harm is acknowledged by staff, yet it is poorly understood.…”

“…Within the prison environment self-harm is especially costly and puts a significant strain on service resources. Not surprisingly, staff report feeling increased frustration and powerlessness (Marzano, Adler & Ciclitira, 2013), and often hold negative, dismissive and hostile attitudes towards offenders (e.g., Knowles, Townsend & Anderson, 2013;Marzano, Ciclitira, & Adler, 2012). This costly nature of self-harm combined with the larger male prison population, means that understanding and treating self-harm in male offenders is a priority.…”

Public perceptions of self-harm—A test of an attribution model of public discrimination.

“…It is, therefore, important to ascertain not only factors that may affect the interpretation of self-harmful behaviors, but also those that predict the provision or denial of a helping response. The literature suggests controllability of cause, with theoretical pertinence in attributional analysis (Weiner, 1980(Weiner, , 1985, and perceived motivations (Knowles, Townsend, & Anderson, 2013) may be key variables to consider. creased attribution of controllability leads to decreased provision of help as well as increased rejecting behaviors; a desire for social distance.…”