Hearing the voices of young people who self‐harm: Implications for service providers

McAndrew, Sue; Warne, Tony

doi:10.1111/inm.12093

Cited by 42 publications

(66 citation statements)

References 37 publications

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“…Participants were predominantly female. Only one study described participant ethnicity (McAndrew & Warne, ). One study was concerned solely with a suicidal population (Murray & Wright, ).…”

Section: Resultsmentioning

confidence: 99%

“…One study was concerned solely with a suicidal population (Murray & Wright, ). McAndrew and Warne () participants had experience of self‐harm or suicidal behaviour. Idenfors et al.…”

Section: Resultsmentioning

confidence: 99%

“…Translation of first (Idenfors et al., ; McAndrew & Warne, ) and second order data (Idenfors et al., ; McAndrew & Warne, ) revealed that CYP found services difficult to access; not knowing where, or how to access help, and being frustrated at not being able to access services directly themselves. For example:

I did not have a clue in the slightest, I didn't know there was [a] Child and Adolescent Mental Health Service (CAHMs) (Fiona).…”

Section: Resultsmentioning

confidence: 99%

“…For example:

I did not have a clue in the slightest, I didn't know there was [a] Child and Adolescent Mental Health Service (CAHMs) (Fiona). (McAndrew & Warne, :575)…”

Section: Resultsmentioning

confidence: 99%

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Review: The views and experiences of suicidal children and young people of mental health support services: a meta‐ethnography

Gilmour

Ring

Maxwell

2019

Child Adoles Ment Health

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Background Suicide is amongst the leading causes of death in young people globally and a health priority worldwide. For children and young people (CYP) attempting or considering suicide there is no agreed treatment model. Development of treatment models should be informed by the views and experiences of CYP using services. Methods Meta‐ethnography was used to systematically identify and synthesise studies reporting the views of CYP who used mental health services following suicidal behaviour. Relevant studies were quality appraised. First order (participants) and second order (original author) data were translated to identify common and disconfirming themes and concepts. Translated findings were synthesised and led to a new hypothesis supported by additional ‘linguistic analysis’ of texts to construct a novel third order line‐of‐argument. Results Four studies conducted since 2006 in three countries involving 44 young people aged 11–24 years were synthesised. Translation revealed that suicidal CYP do not know where or how to access help, they cannot access help directly and when seen by mental health practitioners they do not feel listened to. Line‐of‐argument synthesis identified a silence around suicidality within the conversations CYP have with mental health practitioners and within academic research reporting. Use of the term ‘self‐harm’ to encompass suicidal behaviours potentially contributes to this silence by avoiding the word ‘suicide’. Conclusions Children and young people who are suicidal need to have easy access to mental health services. When using services, they want to feel listened to and have suicidal feelings acknowledged. This involves professionals referring explicitly to suicide not just self‐harm.

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“…Participants were predominantly female. Only one study described participant ethnicity (McAndrew & Warne, ). One study was concerned solely with a suicidal population (Murray & Wright, ).…”

Section: Resultsmentioning

confidence: 99%

“…One study was concerned solely with a suicidal population (Murray & Wright, ). McAndrew and Warne () participants had experience of self‐harm or suicidal behaviour. Idenfors et al.…”

Section: Resultsmentioning

confidence: 99%

I did not have a clue in the slightest, I didn't know there was [a] Child and Adolescent Mental Health Service (CAHMs) (Fiona).…”

Section: Resultsmentioning

confidence: 99%

“…For example:

I did not have a clue in the slightest, I didn't know there was [a] Child and Adolescent Mental Health Service (CAHMs) (Fiona). (McAndrew & Warne, :575)…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Review: The views and experiences of suicidal children and young people of mental health support services: a meta‐ethnography

Gilmour

Ring

Maxwell

2019

Child Adoles Ment Health

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“…There is a culture of fear amongst staff (Best, ; Dowling & Doyle, ), with many school professionals feeling ill equipped to manage behaviours (Berger, Hasking, & Reupert, 2014a, 2014b; De Riggi et al., ). This often leads to the escalation of incidents through the hierarchical school structure in the effort to locate ‘expertise’, which often comes from an external source (Berger et al., 2014b; Best, ; McAndrew & Warne, ). If these management strategies are entrenched and recognised, they might prevent the introduction of school‐based interventions, impinge upon the activation of an intervention's mechanisms of change as intended, or influence what new practices might be deemed acceptable and feasible.…”

Section: Introductionmentioning

confidence: 99%

Adolescent self‐harm prevention and intervention in secondary schools: a survey of staff in England and Wales

Evans

Parker

Russell

et al. 2018

Child Adoles Ment Health

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Background Adolescent self‐harm is a major public health concern. To date there is a limited evidence‐base for prevention or intervention, particularly within the school setting. To develop effective approaches, it is important to first understand the school context, including existing provision, barriers to implementation, and the acceptability of different approaches. Methods A convenience sample of 222 secondary schools in England and Wales were invited to participate in a survey, with a 68.9% (n = 153) response rate. One member of staff completed the survey on behalf of each school. Participants responded to questions on the existing provision of adolescent self‐harm prevention and intervention, barriers to delivery, and future needs. Results Adolescent self‐harm is an important concern for senior management and teachers. However, emotional health and well‐being is the primary health priority for schools. Health services, such as Child and Adolescent Mental Health Services, and on‐site counselling are the main approaches schools currently use to address adolescent self‐harm, with counselling cited as the most useful provision. Fifty‐two per cent of schools have received some staff training on adolescent self‐harm, although only 22% rated the adequacy of this training as high. Where schools do not have existing provision, respondents stated that they would like staff training, specialist student training, external speakers, posters and assemblies, although the latter four options were infrequently ranked as the most useful approaches. Key barriers to addressing adolescent self‐harm were: lack of time in the curriculum; lack of resources; lack of staff training and time; and fear of encouraging self‐harm amongst adolescents. Conclusions Adolescent self‐harm is a priority for schools. Intervention might focus on increasing the availability of training to teaching staff.

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Why do children and adolescents (not) seek and access professional help for their mental health problems? A systematic review of quantitative and qualitative studies

Radež

Reardon

Creswell

et al. 2020

Eur Child Adolesc Psychiatry

404

331

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Mental health disorders in children and adolescents are highly prevalent yet undertreated. A detailed understanding of the reasons for not seeking or accessing help as perceived by young people is crucial to address this gap. We conducted a systematic review (PROSPERO 42018088591) of quantitative and qualitative studies reporting barriers and facilitators to children and adolescents seeking and accessing professional help for mental health problems. We identified 53 eligible studies; 22 provided quantitative data, 30 provided qualitative data, and one provided both. Four main barrier/facilitator themes were identified. Almost all studies (96%) reported barriers related to young people's individual factors, such as limited mental health knowledge and broader perceptions of help-seeking. The second most commonly (92%) reported theme related to social factors, for example, perceived social stigma and embarrassment. The third theme captured young people's perceptions of the therapeutic relationship with professionals (68%) including perceived confidentiality and the ability to trust an unknown person. The fourth theme related to systemic and structural barriers and facilitators (58%), such as financial costs associated with mental health services, logistical barriers, and the availability of professional help. The findings highlight the complex array of internal and external factors that determine whether young people seek and access help for mental health difficulties. In addition to making effective support more available, targeted evidence-based interventions are required to reduce perceived public stigma and improve young people's knowledge of mental health problems and available support, including what to expect from professionals and services.

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Hearing the voices of young people who self‐harm: Implications for service providers

Abstract: ABSTRACT:

Cited by 42 publications

References 37 publications

Review: The views and experiences of suicidal children and young people of mental health support services: a meta‐ethnography

Review: The views and experiences of suicidal children and young people of mental health support services: a meta‐ethnography

Adolescent self‐harm prevention and intervention in secondary schools: a survey of staff in England and Wales

Why do children and adolescents (not) seek and access professional help for their mental health problems? A systematic review of quantitative and qualitative studies

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