Experiences of Accessing Psychological Therapies for Self-Harm: A Qualitative Study of Stakeholders' Perspectives

Objectives Whilst rates of self-harm are rising in the UK people who self-harm can often struggle to access appropriate treatment. This study sought to explore adult stakeholders’ perspectives and experiences of the barriers to, and facilitators of, accessing support for self-harm and also how services could be better tailored to meet needs. Design A cross-sectional qualitative study. Methods Semi-structured interviews were conducted remotely with 19 participants in the UK, including 10 individuals with lived experience of self-harm and nine mental health professionals that worked with people who self-harm. Reflexive thematic analysis was used to analyse the data. Results Both stakeholder groups felt that services did not offer appropriate support, there were system-level challenges and a sense of associated powerlessness. It was important to understand the person behind the behaviour, as a lack of understanding was reported to increase feelings of shame. Services that prioritise person-centred care, expert-by-experience involvement, and early intervention were valued. Professionals outlined the positives of brief interventions, whilst individuals who self-harm held concerns about whether briefer interventions addressed complex difficulties. Conclusions Findings highlight important organisational barriers and potential facilitators that individuals who self-harm may face when accessing psychological interventions. Results prompt to the need for inclusive and easily accessible services.