Young Peoples’ Perspectives on the Role of Harm Reduction Techniques in the Management of Their Self-Harm: A Qualitative Study

Davies, Jessica; Pitman, Alexandra; Bamber, Victoria; Billings, Jo; Rowe, Sarah

doi:10.1080/13811118.2020.1823916

Cited by 12 publications

(14 citation statements)

References 29 publications

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“…Our findings suggest that the majority of people with records reporting harm minimisation find it helpful; this is consistent with previous studies reporting patients’ and practitioners’ positive opinions on harm minimisation and the need to be flexible when approaching self-harm behaviour. 24 , 27 However, the British study described above reported that 7% of participants using harm-minimisation approaches perceived them as ineffective or unhelpful. 26 Another, recent UK-based study interviewed 126 adolescents in the community aged between 11- and 21-years-old and found a third perceived harm minimisation as helpful, a third were indifferent and a third perceived harm minimisation as unhelpful.…”

Section: Discussionmentioning

confidence: 99%

“…This is consistent with the views of professionals and carers over which techniques are regarded as ‘safer’ or less controversial. 27 …”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have reported patients’ concerns over harm minimisation contributing to an increase in tolerance to pain and sensation seeking. 18 , 27 Other work describes the concerns of practitioners and carers regarding the potential for harm minimisation to escalate the severity of self-harm over time. 20 , 38 Specific concerns were raised over the potential for anatomical knowledge to increase the risk of a more severe and potentially fatal injury.…”

Section: Discussionmentioning

confidence: 99%

“…We initially developed a set of inclusive search terms informed by available, but limited, literature such as National Institute for Health and Care Excellence (NICE) guidelines, 14 previous qualitative research 23 , 26 , 27 and through discussions with clinical experts. We used an iterative approach, defining and including search terms that were sensitive enough for inclusion, but specific enough so that the search did not capture harm reduction in the context of substance misuse.…”

Section: Methodsmentioning

confidence: 99%

“… 26 Another qualitative study analysed data with 11 adolescents and identified mixed views on harm minimisation; although some found that harm minimisation gave them greater competence at managing their self-harm, others described this as short lived, and expressed concerns about the potential for some individuals to misuse this knowledge. 27 Conflicting findings from these few qualitative studies may reflect their low numbers of participants and specific sampling approaches; there is a need for larger-scale studies describing the prevalence and nature of the practice of harm minimisation in clinical services. 14 , 20 …”

Section: Research Into Harm Minimisationmentioning

confidence: 99%

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Harm minimisation for the management of self-harm: a mixed-methods analysis of electronic health records in secondary mental healthcare

et al. 2021

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Background Prevalence of self-harm in the UK was reported as 6.4% in 2014. Despite sparse evidence for effectiveness, guidelines recommend harm minimisation; a strategy in which people who self-harm are supported to do so safely. Aims To determine the prevalence, sociodemographic and clinical characteristics of those who self-harm and practise harm minimisation within a London mental health trust. Method We included electronic health records for patients treated by South London and Maudsley NHS Trust. Using an iterative search strategy, we identified patients who practise harm minimisation, then classified the approaches using a content analysis. We compared the sociodemographic characteristics with that of a control group of patients who self-harm and do not use harm minimisation. Results In total 22 736 patients reported self-harm, of these 693 (3%) had records reporting the use of harm-minimisation techniques. We coded the approaches into categories: (a) ‘substitution’ (>50% of those using harm minimisation), such as using rubber bands or using ice; (b) ‘simulation’ (9%) such as using red pens; (c) ‘defer or avoid’ (7%) such as an alternative self-injury location; (d) ‘damage limitation’ (9%) such as using antiseptic techniques; the remainder were unclassifiable (24%). The majority of people using harm minimisation described it as helpful (>90%). Those practising harm minimisation were younger, female, of White ethnicity, had previous admissions and were less likely to have self-harmed with suicidal intent. Conclusions A small minority of patients who self-harm report using harm minimisation, primarily substitution techniques, and the large majority find harm minimisation helpful. More research is required to determine the acceptability and effectiveness of harm-minimisation techniques and update national clinical guidelines.

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Section: Discussionmentioning

confidence: 99%

“…This is consistent with the views of professionals and carers over which techniques are regarded as ‘safer’ or less controversial. 27 …”

Section: Discussionmentioning

confidence: 99%