Exploring Lived Experiences of Adolescents Presenting with Self-Harm and Their Views about Suicide Prevention Strategies: A Qualitative Approach

Abstract

Suicide is a serious global public health problem and the third leading cause of death in those 15–35 years old. Self-harm is the major predictor of future suicide attempts and completed suicide yet remains poorly understood. There is limited evidence on effective interventions for adolescents who present with self-harm. To identify and develop acceptable preventive and therapeutic interventions it is essential to understand the factors that contribute to self-harm and suicide in young people, in the context of their emotions, interpersonal difficulties, available support and prevention strategies. This qualitative study aimed at exploring the lived experiences of adolescents presenting with self-harm and their views about potential prevention strategies. Semi-structured interviews with 16 adolescents (12–18 years) presenting with a self-harm episode in a public hospital in Pakistan. A topic guide was developed to facilitate the interviews. The following themes emerged using the framework analysis; predisposing factors (interpersonal conflicts, emotional crisis etc.), regret and realization that self-harm is not the only option, perceived impact of self-harm, and suggestions for suicide prevention strategies (sharing, distraction techniques, involvement of family). This study may help in refining a contextual and culturally based explanatory model of self-harm in adolescents and in informing development of culturally acceptable interventions.

The Risk-Taking and Self-Harm Inventory for Adolescents: Validation of the Italian Version (RTSHIA-I)

“…This can be the starting point for a clinical intervention that simultaneously considers both types of behaviors, providing the opportunity to act promptly and comprehensively for the adolescent’s well-being. In this regard, the availability of the Italian version of the RTSHIA will facilitate more accurate assessments of the treatment effects of cultural-tailored interventions or prevention strategies (for the relevance of the cultural differences see, for example, [ 67 ]). The assessment of risk-taking and self-harm behavior is relevant also from a preventive perspective: studying the impact on the severe restrictions due to COVID-19 in Italy, De Luca and colleagues [ 68 ] found that the adolescents considered vulnerable in the pre-pandemic period are at high risk of engaging in SH in the post-pandemic period.…”

Prevention of non-suicidal self-injury: construction and validation of educational material

“…Adolescents with NSSI report negative experiences such as misunderstanding, judgment and lack of empathy and credibility when seeking health care (9)(10) .…”

“…Adolescents with NSSI report negative experiences such as misunderstanding, judgment and lack of empathy and credibility when seeking health care 9 - 10 . Health professionals also highlight the lack of formal training, governability and a feeling of unpreparedness to provide health care to adolescents with NSSI 11 .…”