@article{ref1,
title="How people who self-harm negotiate the inpatient environment: the mental-healthcare workers perspective",
journal="Journal of Psychiatric and Mental Health Nursing",
year="2017",
author="Thomas, Jay B. and Haslam, Cheryl O.",
volume="24",
number="7",
pages="480-490",
abstract="INTRODUCTION: Literature describes self-harm as functional and meaningful. This creates difficulties for service-users detained in an inpatient environment where self-harm is prevented. <br><br>AIM: Mental-healthcare staff were interviewed to build on existing evidence of issues with the prevention approach and explore, from a staff perspective, how self-harm prevention impacts on service-users, how they manage distress and how this impacts on staff approach to care. <br><br>METHODS: Qualitative methods were used to allow unexpected themes to arise. Ten semi-structured interviews were carried out with mental-healthcare staff and thematically analysed. <br><br>FINDINGS AND DISCUSSION: The findings provide new evidence on the benefits and limitations of the inpatient environment for individuals who self-harm. <br><br>FINDINGS indicate that being unable to self-harm can lead to a continuation of distress and subsequent potentially-harmful attempts to manage distress. Staff described experiencing a struggle for control in preventing self-harm, leading to increasingly harmful methods of self-harm. Alternatively some staff were able to support service-users with distress management. We discuss factors influencing which of these 'paths' service-users followed. IMPLICATIONS: Considerations for care planning including understanding self-harm, using individualised care-planning and attending to barriers are outlined with the ultimate aim of reducing distress and the impact of prevention of self-harm. This article is protected by copyright. All rights reserved.<br><br>This article is protected by copyright. All rights reserved.<p /> <p>Language: en</p>",
language="en",
issn="1351-0126",
doi="10.1111/jpm.12384",
url="http://dx.doi.org/10.1111/jpm.12384"
}