Harm reduction as a strategy for supporting people who self-harm on mental health wards the views and experiences of practitioners.pdfVIP

Journal of Affective Disorders 214 (2017) 67–73 Contents lists available at ScienceDirect Journal of A?ective Disorders journal homepage: /locate/jad Research paper Harm reduction as a strategy for supporting people who self-harm on mental health wards: the views and experiences of practitioners Karen Jamesa,?, Isaac Samuelsb, Paul Moranc, Duncan Stewartd a Kingston University and St Georges University of London, Joint Faculty of Health, Social Care and Education, London, SW17 ORE United Kingdom b Person with lived-experience of self-harm, United Kingdom c School of Social and Community Medicine, University of Bristol, United Kingdom d Mental Health and Addiction Research Group, University of York, United Kingdom MARK ARTICLE INFO Keywords: Self-harm Harm reduction Inpatient Crisis care Mental health nursing ABSTRACT Background: Harm reduction has had positive outcomes for people using sexual health and substance misuse services. Clinical guidance recommends these approaches may be appropriately adopted by mental health practitioners when managing some people who self-harm. There has, however, been very little research in this area. Methods: We explored practitioners’ views of harm reduction as a strategy for supporting people who selfharm. The Self Harm Antipathy Scale (SHAS) was administered to a random sample of 395 mental health practitioners working on 31 wards in England, semi-structured interviews were then conducted with 18 survey respondents. Results: Practitioners who had implemented the approach reported positive outcomes including a reduction in incidence and severity of self-harm and a perceived increase in empowerment of service users. Practitioners with no experience of using harm reduction were concerned that self-harm would increase in severity, and were unsure how to assess and manage risk in people under a harm reduction care plan. Some fundamentally disagreed with the principle of harm reduction for self-harm because it challenged their core beli