The PARALLEL Study (imPAct of expeRiencing Another’s seLf harm and suicidaL bEhaviour in hospitaL)

Pages258-268
DOIhttps://doi.org/10.1108/JFP-01-2017-0001
Published date13 November 2017
Date13 November 2017
AuthorRebecca Hargate,Sharon Howden,Emma Tarpey,Tammi Walker
Subject MatterHealth & social care,Criminology & forensic psychology,Forensic practice,Sociology,Sociology of crime & law,Law enforcement/correctional,Public policy & environmental management,Policing,Criminal justice
The PARALLEL Study (imPAct of
expeRiencing Anothers seLf harm and
suicidaL bEhaviour in hospitaL)
Rebecca Hargate, Sharon Howden, Emma Tarpey and Tammi Walker
Abstract
Purpose The purpose of this paper is to explore the experiences of both staff and patients in a
medium-secure mental health unit of the self-harm and/or suicidal behaviour of others. Suicide and self-harm
is highly prevalent in forensic settings and evidence suggests that experiencing other peoples self-harm and
suicidal behaviour can lead to negative outcomes, both for staff and patients. This is particularly important in
hospitals where patients are highly dependent on staff for support.
Design/methodology/approach Semi-structuredinterviews were conducted with five staff members and
six patients in a medium-secure male mental health unit in the North of England. Data were analysed following
interpretative phenomenological analysis guidelines.
Findings Three dominant themes were identified during analysis: the impact of suicide and self-harm;
the role of others; and the importance of understanding and experience. Various impacts were discussed
including desensitization, negative emotions and the desire to help. Other people played an important role in
protecting against negative impacts, with shared experiences and peer support reported as the biggest
benefits. Experiences of self-harm and suicide were found to increase understanding resulting in more
positive attitudes. Additionally, the importance of training and education was highlighted.
Originality/value Thispaper provides an insight into the experiencesof staff and patients in medium-secure
male mental healthunit, which has benefits to practitioners when consideringsupport mechanisms.
Keywords Qualitative, Impact, Experience, Self-harm, Forensic settings, Suicidal behaviour
Paper type Research paper
Introduction
Patients in forensic services fall into a high-risk category for exposure to self-harm and suicide
(Oddie, 2015). The majority of suicides occur in adult males (World Health Organization, 2016)
and those with a psychiatric diagnosis are eight times more likely to complete suicide (Lee et al.,
2015). Many patients in forensic units have also spent time in prisons where suicide rates are
now at an all-time high (MoJ, 2017). In inpatient settings, self-harm has been found to be a
response to psychological distress or restricted freedom, with prevalence highest on forensic
wards (James et al., 2012). Reported rates of self-harm in forensic units vary widely but are
consistently at least four times higher than the general population (Oddie, 2015).
Definitions for self-harm and suicidal behaviour differ and behaviours can be distinct (Leitner et al.,
2008). However, relationships between suicide and self-harm are often reported (Oddie, 2015) and
self-harm is a key risk factor for suicide (Hawton et al., 2015); around half the people who complete
suicide in prison have a history of self-harm, which increases the risk between 6 and 11 times
(Fazel et al., 2008). This research therefore takes the approach of recognising self-harm and suicidal
behaviour in their own right, but assessing and understanding them in combination (ORourke, 2013).
Previous research has highlighted many negative impacts of experiencing self-harm and suicide,
including feelings of anger, shock, survivor guilt and denial (Ness and Pfeffer, 1990; Walker and
Received 10 January 2017
Revised 13 March 2017
18 April 2017
Accepted 18 April 2017
Rebecca Hargate is a Research
Programme Manager at
LYPFT, Leeds, UK.
Sharon Howden is a
Psychology Team Lead at
Wathwood Hospital,
Rotherham, UK.
Emma Tarpey is a Senior
Lecturer at the Department of
Psychology, Manchester
Metropolitan University,
Manchester, UK.
Tammi Walker is a Senior
Lecturer at the Division of
Psychology and Mental Health,
University of Manchester,
Manchester, UK.
PAGE258
j
JOURNAL OF FORENSIC PRACTICE
j
VOL. 19 NO. 4 2017, pp. 258-268, © Emerald Publishing Limited, ISSN 2050-8794 DOI 10.1108/JFP-01-2017-0001

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