Self-harm in the community : staff and parent perspectives

Research indicates that mental health staff experience shock, distress and powerlessness when supporting people who self-harm. Existing studies have focused on inpatient staff, neglecting the voices of those working in community settings. AIM: The aim of the current systematic review and thematic synthesis was to explore community staff experiences of supporting people who self-harm. METHODS: PsycINFO, MEDLINE, CINAHL and Web of Science were searched from inception to 4th February 2025. Searches found 3,035 records, of which twelve reporting on 82 participants were identified as meeting the inclusion criteria and included in the synthesis. The Critical Appraisal Skills Programme Qualitative Checklist was used to assess the quality of included studies. RESULTS: Studies took place in the UK, USA, Ireland and Canada. All studies were qualitative recruiting Counsellors, Community Mental Health Nurses, Psychotherapists and a Social Care Support Worker. Studies obtained an average quality rating score of 17.9 out of 20, with most studies being highly rated. Thematic synthesis yielded five themes; 1) Staff experience an all-consuming, long-lasting emotional whirlwind, 2) Staff feel stuck between a rock and a hard place, 3) Staff see systemic challenges as impacting their support of people who self-harm, 4) Staff carry the weight of many different responsibilities, 5) It is necessary for staff to have ways of coping. CONCLUSION: A lack of consensus in the conceptualisation of self-harm highlights a need for researchers’ transparency regarding their theoretical position. The findings highlight the challenging experience staff have when supporting people who self-harm, warranting a need for further support and training.