Young Persons’ Experiences of Inpatient Care for Self-Harm: A Qualitative Exploration

Abstract

In the UK, self-harm is a major healthcare problem. Self-harm is an especially common behaviour in young people admitted to psychiatric inpatient care and is one of the primary reasons for presenting to hospital. The management and treatment of self-harming behaviours can be challenging, and few treatment guidelines are available for inpatient settings. Poor understanding of self-harm and how to manage it effectively is likely to lead to staff feeling hopeless and helpless, but also to reduced support for the young people under their care. The current study constitutes an attempt to build on what is known by exploring young people’s reports on their experiences of inpatient treatment when presenting with self-harm. A grounded theory methodology was used to analyse the data. There were two key study aims which were: to obtain young people’s reports on their experiences of inpatient care when presenting with self-harm; and to integrate these views into a grounded theory that would serve as a model for understanding features of young persons’ experiences of inpatient care when presenting with self-harm. Semi-structured interviews were conducted at two NHS mental health inpatient units. Participants were a convenience sample of 10 young people, aged between 12 and 18 years. Analysis of these interviews was done in accordance with grounded theory. Two core concepts of humanness and restriction emerged from the data which contribute to the construction of meaning and understanding. Service implications and recommendations highlight the need for improved understanding, maintaining relationships and continued connection during admissions. The methodology contributed to developing a rich and detailed understanding of young persons’ experiences of inpatient care when presenting with self-harm.

Keywords: Self-harm, inpatient care, adolescents, mental health, grounded theory, lived experience, qualitative research