TY  - JOUR
PY  - 2016//
TI  - Understanding vulnerability to self-harm in times of economic hardship and austerity: a qualitative study
JO  - BMJ open
A1  - Barnes, M. C.
A1  - Gunnell, David
A1  - Davies, R.
A1  - Hawton, K.
A1  - Kapur, N.
A1  - Potokar, J.
A1  - Donovan, J. L.
SP  - e010131
EP  - e010131
VL  - 6
IS  - 2
N2  - 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. <br><br>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. <br><br>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.<p />  <p>Language: en</p>
LA  - en
SN  - 2044-6055
UR  - http://dx.doi.org/10.1136/bmjopen-2015-010131
ID  - ref1
ER  -