Emergency care following an episode of self-harm: A mixed methods review of user experiences and the nature and impact of knowledge, attitudes and behaviours of first responders

Project overview 

To bring together evidence on the experiences of care received after self-harm from the perspectives of people who self-harm, as well as staff members who care for them, including factors that may explain why people experienced care differently. We will also look for evidence on any interventions that can improve knowledge, attitudes, and behaviours in staff members, and if they have any effect on improving the care experienced by people who self-harm.

Status: ongoing

Contact: mark.rodgers.york.ac.uk 

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What is the problem?

Self-harm refers to intentional behaviours that cause harm to oneself, such as through cutting or poisoning. Although people who self-harm do not always feel suicidal, they are more likely to complete suicide. Those with negative experiences of care may be more likely to attempt suicide in the future to avoid going back to hospitals. Many people have reported negative experiences of care in emergency settings, such as being denied access to pain relief or being faced with negative attitudes from staff members. Staff members have also expressed a lack of confidence and knowledge towards people who self-harm. 

Different factors may explain why some people experienced better care than others, such as their age, whether they have taken drugs or drank alcohol, the time of the day (e.g., during or outside of opening hours), and the type of staff who treated them (e.g., nurses, psychiatrists). 

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What are we doing?

The aim of this review is to bring together evidence on the experiences of care received after self-harm from the perspectives of people who self-harm, as well as staff members who care for them, including factors that may explain why people experienced care differently. We will also look for evidence on any interventions that can improve knowledge, attitudes, and behaviours in staff members, and if they have any effect on improving the care experienced by people who self-harm. The evidence produced by this review will be used to inform policy and practice in the UK to improve care experienced after self-harm, therefore only UK studies will be summarised in detail. Studies from other high-income countries which may be relevant to the will be identified and summarised briefly using an interactive tool, which can be used to explore evidence outside the UK for international researchers.