The Experience and Meaning of Repeated Self-Harm Among Patients Presenting to Irish Hospital Emergency Departments

Abstract

Background

Self-harm is a global public health concern in terms of increasing morbidity in addition to causing considerable financial implications for the health sector. Patients presenting with a history of self-harm are at increased risk of self-harm repetition and suicide. Research exploring the patient’s experience of engaging in multiple self-harm episodes is lacking. This study aimed to explore the experiences and meaning of self-harm repetition, among patients who presented to three urban hospital emergency departments in Ireland.

Method

A subset of participants with a history of five or more self-harm attempts from an ongoing study, ‘Improving Prediction and Risk Assessment of Self-Harm and Suicide’ was selected for this article. Interview transcripts from four participants were selected for analysis using Interpretative Phenomenological Analysis. The qualitative software package NVivo 11 was used to store and organise data into themes.

Results

Data were analysed based on four participants (two males and two females) ranging in age from 25 to 56 years. Three of the four participants reported a history of early traumatic emotional, physical and sexual abuse. Four superordinate themes were generated from the data, ‘Significance of self-harm to the person’, ‘Trajectory of self-harm progression’, ‘Impact of abuse in adult life’ and ‘The road to recovery’.

Conclusion

Self-harm was used as a coping mechanism for participants who experienced distressing life events such as emotional and sexual abuse. The qualitative themes identified in this study have implications for the development of adequate medical and mental health support systems for patients with histories of repeated self-harm.

Acknowledgments

This work was supported by the Irish Health Research Board (grant number: IRRL-2015-1586). The authors would like to thank the primary organisation, the National Suicide Research Foundation, for providing the resources required to conduct this study. The authors would like to take the opportunity to thank all the participants of the study who shared their experiences for the purpose of this research, and without whom this study would not be possible.

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.