Self-harm: what's the problem? A literature review of the factors affecting attitudes towards self-harm

Accessible summary Self-harm injuries account for 150 000 presentations at hospital in the UK in different ward settings. Research has historically shown that people who have self-harmed have negative experiences because of attitudes of the healthcare professionals employed to help them. These negative attitudes remain the main perception from service users and staff in recent published research. Lack of education, lack of personal confidence, clinical problems and perception of client's control of harming behaviour are all blamed for healthcare staffs negative attitudes. A small number of trials have highlighted the benefit of greater education and clinical supervision in improving attitudes which are supported by government guidance. Abstract People who have experienced self-harm report dissatisfaction with the care provided by statutory services. This review provides a critical exploration of the evidence examining the attitudes of healthcare professionals across both mental health and medical settings towards people who self-harm. It also explored in detail service users perceptions of care. A literature search conducted via electronic databases and cross-matching reference lists produced 19 papers that met the inclusion criteria. A thematic analysis of the literature indicated six key areas which contributed to the development of attitudes defined as positive or negative towards people who self-harm. Negative attitudes and experiences of care were associated with lack of education and training, the impact of differences in perceptions of health professionals' role and the influence of clinical culture as well as how self-harm was perceived as a health need. More positive attitudes were associated with a greater understanding of experiences of self-harm and improved training. However, the nature of care reported by service users indicates that there are still significant improvements needed to the attitudes in health settings to ensure they receive a high-quality service.