Understanding vulnerability to selfharm in times of economic hardship and austerity: A qualitative study

Barnes, M. C.; Gunnell, D.; Davies, R.; Hawton, K.; Kapur, N.; Potokar, J.; Donovan, J. L.

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 crosssectionally 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 selfharm. 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.

• Journal Article Type: Article
• Acceptance Date: Dec 15, 2015
• Online Publication Date: Feb 17, 2016
• Publication Date: Feb 17, 2016
• Deposit Date: Jun 27, 2016
• Publicly Available Date: Jun 27, 2016
• Journal: BMJ Open
• Electronic ISSN: 2044-6055
• Publisher: BMJ Publishing Group
• Peer Reviewed: Peer Reviewed
• Volume: 6
• Issue: 2
• Article Number: e010131
• DOI: https://doi.org/10.1136/bmjopen-2015-010131
• Keywords: self-harm, austerity, qualitative
• Public URL: https://uwe-repository.worktribe.com/output/916728
• Publisher URL: http://dx.doi.org/10.1136/bmjopen-2015-010131
• Contract Date: Jun 27, 2016