"These things don't work": young people's views on harm minimisation strategies as a proxy for self-harm: a mixed methods approach

Wadman, Ruth; Nielsen, Emma; O’Raw, Linda; Brown, Katherine; Williams, A. Jess; Sayal, Kapil; Townsend, Ellen

Abstract

Objective: Although UK clinical guidelines make tentative recommendations for 'harm minimisation' strategies for repeated self-harm, this is in the absence of empirical evidence supporting their acceptability or effectiveness. We explore young people's views of harm minimisation strategies (e.g. snapping elastic bands on skin, drawing on skin with red ink), as a proxy for self-harm. Methods: In this mixed methods study we examine data (secondary analysis) from: (1) an online questionnaire (N = 758) observing the frequency of these strategies being used as a form of self-harm, and as a form of alternative coping (viewed as distinct from self-harming), and (2) semi-structured interviews (N = 45), using thematic analysis to identify themes related to harm minimisation. Results: Predominant themes suggest that many young people viewed harm minimisation strategies as a proxy for self-harm as ineffective. Where such strategies were reported as helpful, their utility was reported to be short-lived or situation-specific. Findings from both studies indicate that some young people described using harm minimisation (e.g. elastic band snapping) as a form of self-harm (e.g. to break the skin). Conclusions: Harm minimisation strategies should not be recommended in isolation and their use must be monitored. Further research is urgently needed to develop an evidence base that informs practice.

Citation

Wadman, R., Nielsen, E., O’Raw, L., Brown, K., Williams, A. J., Sayal, K., & Townsend, E. (2019). "These things don't work": young people's views on harm minimisation strategies as a proxy for self-harm: a mixed methods approach. Archives of Suicide Research, 24(3), 1-18. https://doi.org/10.1080/13811118.2019.1624669

• Journal Article Type: Article
• Acceptance Date: May 24, 2019
• Online Publication Date: Jul 19, 2019
• Publication Date: Jul 19, 2019
• Deposit Date: Jun 3, 2019
• Publicly Available Date: Jul 20, 2020
• Journal: Archives of Suicide Research
• Print ISSN: 1381-1118
• Electronic ISSN: 1543-6136
• Publisher: Routledge
• Peer Reviewed: Peer Reviewed
• Volume: 24
• Issue: 3
• Pages: 1-18
• DOI: https://doi.org/10.1080/13811118.2019.1624669
• Keywords: Self-harm; non-suicidal self-injury; suicide; harm minimisation; adolescence
• Public URL: https://nottingham-repository.worktribe.com/output/2130210
• Publisher URL: https://www.tandfonline.com/doi/full/10.1080/13811118.2019.1624669?scroll=top&needAccess=true
• Additional Information: Peer Review Statement: The publishing and review policy for this title is described in its Aims & Scope.; Aim & Scope: http://www.tandfonline.com/action/journalInformation?show=aimsScope&journalCode=usui20; Published: 2019-07-19