‘I’ve been harming myself for 10 years and this is the first time anyone’s spoken to me about it’: a thematic analysis of patients’ experiences of a self-harm pathway on an acute mental health ward

Aims: Ensuring a safe environment for individuals who self-harm is a crucial aspect of inpatient psychiatric care. In recent years, steps have been taken to reduce restrictive practices on mental health wards following episodes of self-harm. A structured, self-harm pathway was evaluated by Peasley Cross Hospital, Mersey Care NHS Foundation Trust. This pathway was adapted and implemented on an acute mental health ward in Gloucestershire. The aim of the current study was to explore patients’ experiences of the pathway. Method: 1:1 interviews were conducted with four patients who had engaged with the pathway. Interviews were transcribed and thematically analysed. Results: The analysis identified four major themes. Three of the these (‘change/breaking the cycle’, ‘multi-directional learning’ and ‘groupwork’) reflected positive feedback from patients. The fourth theme, ‘consistency/inconsistency’, reflected challenges in implementing the pathway with a large team on an acute mental health ward. Conclusions & implications for practice: Patients considered the self-harm pathway to be largely positive, supporting its use on acute mental health wards. Further evaluation is necessary to determine if the pathway has reduced levels of self-harm and restrictive practice on the ward. Future research may consider evaluating the pathway across various clinical settings.