Experiences of accessing psychological therapies for self‐harm: A qualitative study of stakeholders' perspectives

OBJECTIVES: While rates of self-harm are rising in the United Kingdom, 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 United Kingdom, 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. Normalisation Process Theory (NPT) was used as a guiding framework throughout the study. 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, while 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 the need for inclusive and easily accessible services.