The views and experiences of suicidal children and young people of mental health support services: A meta-ethnography.

Background: Suicide is amongst the leading causes of death in young people globally and a health priority worldwide. For children and young people (CYP) attempting or considering suicide there is no agreed treatment model. Development of treatment models should be informed by the views and experiences of CYP using services. Methods: Meta-ethnography was used to systematically identify and synthesise studies reporting the views of CYP who used mental health services following suicidal behaviour. Relevant studies were quality appraised. First order (participants) and second order (original author) data were translated to identify common and disconfirming themes and concepts. Translated findings were synthesised and led to a new hypothesis supported by additional ‘linguistic analysis’ of texts to construct a novel third order line-of-argument. Results: Four studies conducted since 2006 in three countries involving 44 young people aged 11-24 years were synthesised. Translation revealed that suicidal CYP do not know where or how to access help, they cannot access help directly and when seen by mental health practitioners they do not feel listened to. Line-of-argument synthesis identified a silence around suicidality within the conversations CYP have with mental health practitioners and within academic research reporting. Use of the term ‘self-harm’ to encompass suicidal behaviours potentially contributes to this silence by avoiding the word ‘suicide’. Conclusions: CYP who are suicidal need to have easy access to mental health services. When using services, they want to feel listened to and have suicidal feelings acknowledged. This involves professionals referring explicitly to suicide not just self-harm

Professional care after deliberate self-harm: a qualitative study of young people’s experiences

Hans Idenfors, Gunnar Kullgren, Ellinor Salander Renberg Department of Clinical Sciences, Division of Psychiatry, Umeå University, Umeå, Sweden Background: Deliberate self-harm (DSH) is increasingly common among young people. At the same time, treatment and support after DSH are often hampered by low compliance.Aim: To explore young people’s perceptions of care and support during a 6-month period following their first contact for DSH.Methods: We conducted nine semistructured interviews with young people aged 16–24 years 6 months after their first contact for DSH. The interviews were analyzed using qualitative content analysis.Results: Three main themes were extracted from the interviews. “Am I really in good hands?” describes whether the participants felt they were being listened to and taken seriously and whether they could rely on the competence of the professionals and the appropriateness of treatment, including keeping agreements and communication with other relevant agencies. “Help should match life circumstances” comprises how basic practicalities such as travel possibilities affect treatment and concomitant assistance in everyday living. Financial matters and jobseeking were perceived as necessary for optimal treatment and well-being. “Making yourself better” includes participants’ efforts to manage on their own, through realizing their own responsibility to be engaged and actively take part in treatment planning.Conclusion: Flexibility and responsiveness to young people’s own views and specific needs in treatment arrangements are of crucial importance. The significance of basic practical help cannot be underestimated and should not be overlooked. Keywords: young adults, deliberate self-harm, qualitative, treatment experience