Self-harm attempters’ perception of community services and its implication on service provision

Abstract

Objective This study aimed at exploring the attempters’ perception of community social services included any barriers to seeking help and services. Method The participants were patients with self-harming behavior aged 15 years or above. A set of guiding questions were designed to explore the general barriers and accessibility to community social services. A voice recording was made, which was later converted into a text transcript and then preceded for content analysis with co-occurrence and similarity matrix interpretation. Two males and nine females with a history of self-harm aged between 24 and 58 years were recruited for the interviews. Result The participants had diverse experiences and backgrounds, and attitudes toward community social services. However, there was a shared perception of the need to enhance community social services. There were four main themes and 12 sub themes identified. The main theme included the service availability, service accessibility, affordability and acceptability. For details, participants were unaware of the available types of care/social services in the community, and were unaware about the nearby social services. They also suggested extending service hours and focused services should be offered to help people with different backgrounds and needs. Actually, those with experience of service utilization had both positive and negative perspectives and they gave suggestions for service delivery, mainly extending service hours and offering focused services such as for gambling control and financial planning. In view of interaction with service providers, counseling skills and trust were highly appreciated by the participants. Conclusion The results identified common circumstances of falling into financial hardship (gambling) and social fragmentation (divorce, poor family relationships, and poor marital relationships), which also suggested to enhance services on center location, service arrangement, and skill of caregivers.

Gambling-related suicides and suicidality: A systematic review of qualitative evidence

“…In some studies ( 53 – 55 ), gambling itself was described as the generic cause of suicide. Leung et al ( 54 ) interviewed suicidal or self-harming individuals and found that pathological gambling was identified as one of the main contributing factors for self-harm. A case study of an individual in Estonia having committed familicide ( 55 ) found that the person had not exhibited suicidal behavior before commencing heavy gambling on electronic gambling machines (EGMs).…”

“…Other life situation related issues appear to have rather stemmed from gambling or emerged after gambling had commenced. These related notably to interpersonal problems and relationship difficulties ( 36 , 53 , 54 ) or to problems at study or work ( 36 , 53 ). These are typically related to gambling debts and losses [also Blaszczynski and Farrell ( 36 )].…”

“…The types of treatment received were also discussed in a few of the included studies ( 36 , 40 , 54 , 55 , 69 ). Although observations are not many, findings suggest that the more comprehensive and specialized the treatment and support approach, the better the results.…”

Suicide rates among people with serious mental illness: a systematic review and meta-analysis

“…In addition, most individuals have health system contact prior to suicide, which means opportunities for suicide prevention in primary care or medical specialty settings (Ahmedani et al, 2014). Therefore, it is important to introduce various service changes related to ward safety, community services, training, and policy and guidance (Kapur et al, 2016; Leung, Chow, Ip, & Yip, 2019).…”

Psychiatric patients’ experience in receiving services provided by non-specialist community nurses, southern Thailand

“…The point is how to create understanding and reframe the patient’s confidence in home visiting to be positive (Grant, 2015), and how to work with the community to reduce stigmatization in mental illness. Supporting the competency of community nurses can enhance the effectiveness of psychiatric care while providing primary care (Leung et al, 2019).…”