Understanding vulnerability to self-harm in times of economic hardship and austerity: a qualitative study. Issue 2 (17th February 2016)

• Record Type: Journal Article
• Authors: Barnes, M C; Gunnell, D; Davies, R; Hawton, K; Kapur, N; Potokar, J; Donovan, J L
• Is Part Of: BMJ open. Volume 6:Issue 2(2016)
• Publication Date: 2016-02-17
• Subjects: QUALITATIVE RESEARCH -- SOCIAL MEDICINE; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2015-010131
• Languages: English
• ISSNs: 2044-6055

Abstract

Abstract : Objective: Self-harm and suicide increase in times of economic recession, but little is known about why people self-harm when in financial difficulty, and in what circumstances self-harm occurs. This study aimed to understand events and experiences leading to the episode of self-harm and to identify opportunities for prevention or mitigation of distress. Setting: Participants' homes or university rooms. Participants: 19 people who had attended hospital following self-harm in two UK cities and who specifically cited job loss, economic hardship or the impact of austerity measures as a causal or contributory factor. Primary and secondary outcome measures: Semistructured, in-depth interviews. Interviews were audio recorded, transcribed and analysed cross-sectionally and as case studies. Results: Study participants described experiences of severe economic hardship; being unable to find employment or losing jobs, debt, housing problems and benefit sanctions. In many cases problems accumulated and felt unresolvable. For others an event, such as a call from a debt collector or benefit change triggered the self-harm. Participants also reported other current or past difficulties, including abuse, neglect, bullying, domestic violence, mental health problems, relationship difficulties, bereavements and low self-esteem. These contributed to their sense of despair and worthlessness and increased their vulnerability to self-harm. Participants struggled to gain the practical help they felt they needed for their economic difficulties or therapeutic support that might have helped with their other co-existing or historically damaging experiences. Conclusions: Economic hardships resulting from the recession and austerity measures accumulated or acted as a 'final straw' to trigger self-harm, often in the context of co-existing or historically damaging life-experiences. Interventions to mitigate these effects should include providing practical advice about economic issues before difficulties become insurmountable and providing appropriate psychosocial support for vulnerable individuals.