Pathways to episodes of deliberate self‐harm experienced by mentally ill men in a high‐secure hospital over the course of their lives: an exploratory study

Abstract

PurposeThere is a dearth of research exploring pathways to episodes of deliberate self‐harm (DSH) within mentally ill men in high‐secure hospitals. This study aims to explore pathway(s) to episodes of self‐harm experienced by this group over the course of their life.Design/methodology/approachA total of seven men with a history of repetitive DSH participated in audio‐taped semi‐structured interviews. Transcribed interviews were analysed using grounded theory methods.FindingsTwo pathways to episodes of DSH emerged and were termed: the relief, and the response to mental health problems pathways. Participation within a dyadic suicide pact emerged as an unexpected theme.Research limitations/implicationsThere were a number of limitations within this study. Participants did not describe DSH episodes, which occurred within the high‐secure hospital and it was unclear as to the stage of their illness or whether co‐morbid difficulties were present during the episodes of DSH. Further research is required to substantiate the two pathways to episodes of DSH found within this study.Practical implicationsThe present study offers a theoretical framework for clinicians working with mentally ill men within high‐secure hospitals, who have a history of DSH and identifies the need to carefully assess each individual episode of DSH.Originality/valueThis study is the first to explore pathways to episodes of self‐harm as experienced by mentally ill men within a high‐secure hospital by interviewing patients directly.