The functions of self‐harm in young people and their perspectives about future general practitioner‐led care: A qualitative study

Background Self-harm in young people is a serious concern but a deeper understanding of the functions of self-harm in young people can tailor care and inform new clinical interventions to reduce repeat self-harm and suicide risk. General practitioners (GPs), as frontline healthcare professionals, have an important role in managing self-harm in young people. This study aimed to explore the functions of self-harm in young people and their perspectives on future GP-led care. Methods A qualitative study using interviews with young people aged between 16 and 25 years with a personal history of self-harm was conducted. Interviews were transcribed and analysed using reflexive thematic analysis. Findings Four distinct functions were identified: (1) handling emotional states; (2) self-punishment; (3) coping with mental illness and trauma; and (4) positive thoughts and protection. Young people valued GP-led support and felt future GP interventions should include self-help and be personalised. Conclusions These findings support clinicians, including GPs, to explore the functions of self-harm in young people aged 16–25 in a personalised approach to self-harm care. It should be noted that self-harm may serve more than one function for a young person and thus interventions should recognise this. Patient and Public Contribution A group consisting of young people with lived experience of self-harm, carers, the public, and those who work with young people who harm themselves conceived this study idea, informed recruitment methods and the interview topic guide, and supported the interpretation of findings

The functions of self‐harm in young people and their perspectives about future general practitioner‐led care: A qualitative study

Background: Self‐harm in young people is a serious concern but a deeper understanding of the functions of self‐harm in young people can tailor care and inform new clinical interventions to reduce repeat self‐harm and suicide risk. General practitioners (GPs), as frontline healthcare professionals, have an important role in managing self‐harm in young people. This study aimed to explore the functions of self‐harm in young people and their perspectives on future GP‐led care. Methods: A qualitative study using interviews with young people aged between 16 and 25 years with a personal history of self‐harm was conducted. Interviews were transcribed and analysed using reflexive thematic analysis. Findings: Four distinct functions were identified: (1) handling emotional states; (2) self‐punishment; (3) coping with mental illness and trauma; and (4) positive thoughts and protection. Young people valued GP‐led support and felt future GP interventions should include self‐help and be personalised. Conclusions: These findings support clinicians, including GPs, to explore the functions of self‐harm in young people aged 16–25 in a personalised approach to self‐harm care. It should be noted that self‐harm may serve more than one function for a young person and thus interventions should recognise this. Patient and Public Contribution: A group consisting of young people with lived experience of self‐harm, carers, the public, and those who work with young people who harm themselves conceived this study idea, informed recruitment methods and the interview topic guide, and supported the interpretation of findings

Perceived Causes of Postnatal Depression

Summary This thesis aims to provide an understanding of the perceived causes of Postnatal Depression (PND). Despite increasing research exploring the aetiology and risk factors for PND, to date, little research has explored how individuals perceive the causes of PND. The first part of this thesis reviews the literature on causal beliefs in adults in clinical, community and general population samples. Thirteen papers were critically appraised to reveal insights into these perceived causes. Beliefs were grouped into four emergent themes: (1) biological; (2) psychological; (3) social; and (4) cultural (including religious). The review identified a need to explore how PND is understood culturally, particularly amongst lay individuals from minority faith and ethnic groups. In accordance with these recommendations, the second part of this thesis is a Q-methodological study of the perceived causes of PND amongst British Muslim women of Arab origin. The sample comprised eleven participants recruited from a community organisation. Participants sorted 50 statements, each detailing a possible cause of PND, according to how much they believed them to be causes of PND. Findings identified two clear and distinct accounts: stress-generation and diathesis-stress, significant in causing PND. Although both accounts were clearly embedded in faith and values, the viewpoints operated with a subtly different interpretation of the role of faith in relation to PND. The third paper provides a reflective commentary on the research process, including a methodological critique of the research project and reflections on the personal impact of the research on the researcher. Contrary to the dominant biomedical model, the thesis highlights the existence of wide-ranging, multi-factorial explanatory models for PND. Eliciting and understanding these causal models can help to engage clients and provide culturally sensitive interventions