Self-harm strategy development: qualitative evidence

Introduction: rationale and aims

While understanding the prevalence of self-harm, as well as demographic patterns and trends is important, equally important is understanding the range of meanings and functions that self-harm plays in the lives of people who self-harm, and how it is explained and understood by them. Additionally, qualitative evidence can provide vital insights about what services or supports are effective for those who self-harm.

This literature review addresses gaps in our current understanding of self-harm, using a systematic review and meta-ethnography approach to better understand diverse lived experiences of self-harm. By applying the rigorous principles of meta-ethnography (France et al., 2019; Sattar et al., 2021), this review not only reports and discusses prominent themes within the literature but also seeks to contextualise them. A meta-ethnographic approach to analysis allows the synthesis of the initial participants’ words and the initial study authors’ interpretations alongside new insights derived from considering the full range of studies together. In doing so, this review offers a more nuanced understanding of the experiences of those who self-harm, which aims to situate lived experience within intersecting socio-economic and cultural contexts. We suggest that these new understandings point to a number of potential areas for action, whereby those who self-harm may be better understood and supported.

Research questions for this study are as follows:

1. How do people who self-harm make sense of self-harm; what functions and meanings does it have?

2. How is self-harm related to other social factors in qualitative literature?

3. What experiences do people who self-harm report with services?

4. What messages do answers to the above questions pose for the new self-harm strategy in Scotland?