Speakers and Topics
A. Jess Williams - Research Assistant at Nottingham Trent University
“They aren’t all like that”: perceptions of clinical services, as told by self-harm online communities.
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Authors: A. Jess Williams a, Emma Nielsen b, & Neil S. Coulson c
a Division of Psychology, School of Social Sciences, Nottingham Trent University
b Self-Harm Research Group, School of Psychology, University of Nottingham
c Division of Rehabilitation & Ageing, School of Medicine, University of Nottingham
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Background: Self-harm is a critical public health issue and is the strongest predictor of suicide. However, many who experience self-harm rarely present to clinical services. Due to the anonymity and support offered through online communication, it is possible that online communities may hold useful insights to which factors influence self-harming individuals seeking help. The aim of this study was to explore the perceptions of clinical services within self-harm online communities to understand which services are being used and why.
Method: 3 online communities were identified which fit the inclusion criteria. Threads were randomly selected until saturation was reached. These were analysed using thematic analysis.
Results: A total of 513 messages were posted within 60 threads [mean = 5 messages per thread, range 1-117]. Analysis highlighted 4 key themes. These explored access to appropriate services during an episode of self-harm, service preference, fears around disclosing self-harm, and the impact of support.
Discussion: We consider the communication within self-harm online communities and how this relates to the perceptions of clinical services within this population. The core themes explain why individuals who self-harm may not present, the journey through clinical services and what may act as barriers or facilitators to this attendance across various settings. Particularly evident was the importance of having clear guidelines of confidentiality within services, and that dissatisfaction regarding the access to services which could promote help-seeking disengagement. This awareness of how individuals perceive clinical services and respond, can be used to implement positive responses to encourage help-seeking behaviour.
Dr Kay Inckle - University of Liverpool
Harm-Reduction:
Mainstreaming social justice and user-led interventions for people who hurt themselves.
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This presentation explores the (user-led) history, ethos and practice of harm-reduction as an intervention for people who self-injure. It explores how harm-reduction emerged from the failings of medicalised understandings of self-injury and the misguided and sometimes abusive treatment that people who hurt themselves received. Harm-reduction focuses on the survival functions of self-injury in conjunction with a social justice approach to the distress which underpins it. In this way both the ethos and practice provide an alternative experience of the self and possibilities of choice, control and self-care as well as practical strategies for mitigating risk. In the last twenty years harm-reduction approaches have radically transformed in status. During its early inception harm-reduction was deemed controversial and subject to much fear and misperception in services. In recent years harm-reduction has become recognised as a crucial intervention and has been endorsed within the NICE guidelines.
Biography: Dr Kay Inckle is a lecturer in sociology at the University of Liverpool. She has also worked in health and social services with young people in care and adult psychiatric service-users. These experiences, alongside her own feminist and disability activism, informed her PhD and post-doctoral research with people who self-injure and also led her to work as a specialist training provider delivering courses based on a holistic, social justice and harm-reduction approach to self-injury. In 2017 she published her third book Safe with Self-Injury: A Practical Guide to Understanding, Responding & Harm-Reduction (with PCCS Books).
Dr Rebecca Fish - Lancaster University
'Working with men who self-harm on locked wards'
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Literature about self-harm mainly focuses on women’s experiences; self-harm in men is often overlooked or misdiagnosed as accidental. A small number of researchers have recognised the changing nature of men’s self-harm, acknowledging the wider social influences. This is a particular concern for secure learning disability and mental health services, where male self-harm is becoming more frequent and life threatening. The literature on men’s self-harm more generally, comes from psychiatric services or prisons, no studies to date focus on men with learning disabilities.
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This report details experiences of staff working with learning-disabled men who self-harm in a locked unit, considering their insights into working with this user group. Semi-structured interviews were used to investigate staff’s insights into masculinity and its influence on self-harm as a coping strategy. Staff described very distinct self-harming behaviours on behalf of men, as well as particular meanings of self-harm, which differed from the women they had worked with. Staff offered a number of positive strategies that they use to help men who self-harm.
Stephanie Hannam-Swain - PhD student, Sheffield Hallam University
'Disabled peoples' conceptualisations and experiences of self-harm'
Background: I became interested in self-harm during my Masters Degree. For my thesis I looked at younger peoples' (18-25) experiences of the behaviour compared to older peoples' (60+). During my research I became aware that some of the reasons behind older peoples' self-harm sounded as though they may also apply to disabled people; however I found very little research in this area. I applied to do my PhD at Sheffield Hallam University to investigate this under represented area of self-harm research. The majority of research to do with self-harm is carried out from a psychological perspective however as I want to focus on disabled people I will be approaching it from a Disability Studies perspective.
This talk: In this presentation I will take you on my journey from Masters Degree to my current position in my PhD. I will highlight some of the key literature within self-harm research and offer some critique in relation to this and disabled people. Additionally I will talk about the research which is available which attempts to deal with both.
I will go on to speak about my plans for my own research and I will provide some very initial observations from my pilot study.
Finally I will address some ongoing ethical issues and the conversations that I still need to have with myself about how to best further my research in the most appropriate way.