Nursing Degree Paper - Adolescents That Self-Harm

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Self-harm is considered a major public health issue at present (Mental Health Foundation, 2006. Cleaver, 2007). The National Institute of Clinical Excellence (NICE) describes self-harm as ‘self-poisoning or self-injury, irrespective of the apparent purpose of the act’ (2004:16). The incidence of self-harm in young people appears to be increasing and there is a strong link between self-harm and increased risk of completed suicide (Cleaver, 2007). McDougall and Brophy (2006) produced a summary of the Mental Health Foundation publication, Truth Hurts, examining the implications for nurses and mental health professionals. They report that the incidence of self harm has risen by 30% since the 1980’s and that children are self-harming at increasingly younger ages. The only reference to parents is to state that young people sometimes self harm to ‘cope with... conflict between parents’ (2006:14) and that young people find relatives least helpful of all available support mechanisms.

Storey et al (2005) reported a rising number of young people presenting to Accident and Emergency (A&E) departments. They recruited 74 young people following such presentation though it is not specified how data was gathered from these young people. As participants were referred to as ‘interviewees’ toward the end of the report it can be presumed that interviews were undertaken, though whether these interviews were structured, semi-structured etc is not stated. The study disregarded 16 young people because they did not have a previous history of self-harm prior to the presentation at A&E and a further 20 were disregarded as their first episodes of self-harm occurred after the age of 16. The study aimed to explore the link between self-harm and social support, particularly in relation to family support. The study highlights the negative treatment of young people in ‘treatment’ services, stating that young people feel there is a lack of continuity of services and that they are not listened to. Storey et al found that those with a history of being in care had a greater likelihood of early childhood onset of self-harming behaviour and an increase likelihood of attendance at A&E. However, it is not clear what proportion of disregarded young people also had a history of being in care and whether their inclusion would have resulted in different findings.

In her review of recent studies, Cleaver (2007) states that difficulties can arise when reviewing the available research as there are a number of inconsistencies evident. Firstly, difficulties arise when comparing articles on self-harm as there is no agreed definition of which behaviours constitute self-harm with some authors not including behaviours such as self-poisoning in their definitions of self-harm. Cleaver (2007) argues that many authors do not even agree on the definition of a ‘young person’, making comparison increasingly difficult. Preece (2007), in acknowledging these difficulties, argues that it is difficult to be clear whether incidences have increased or if statistics reflect a broadening of the inclusion criteria.

McDonald et al (2007) identified a lack of research exploring the experience of families. They recruited mothers of self-harming young people via the local news media. 6 Mothers were interviewed to gain an understanding of self-harm within the context of family life. The participants described feeling guilt, shame, feeling overwhelmed and inadequate, feeling they lacked knowledge and understanding of their child’s experience and feeling they had somehow failed their child. McDonald et al argue that the care and concern demonstrated by the participants, challenges the view that all young people who self-harm come from abusive and neglecting families. The participants in this study were from medium to high socioeconomic status families, which the researchers acknowledge could impact on the findings, therefore the generalisability of this study may be...
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