Making sense of self-harm : the context of austerity and drawing on stories of CAMHS clinicians

George, Amber Joy

Clinical psychology
June 2021

Thesis or dissertation


Rights
© 2021 Amber Joy George. All rights reserved. No part of this publication may be reproduced without the written permission of the copyright holder.
Abstract

Self-harm is a growing concern within society and is often understood as reflecting mental ‘illness’. However, attending to the ‘bigger picture’ when thinking about self-harm is helpful for making sense of self-harm, both for individuals and ecologically. This thesis includes a systematic literature review and an empirical study exploring self-harm within the context of austerity, and through hearing stories from Child and Adolescent Mental Health Services (CAMHS) clinicians.
The systematic literature review examined the relationship between self-harm and austerity in the UK and Ireland. The relationships between self-harm and suicide, and suicide and austerity are well established and highlight the need to also understand the relationship between austerity and self-harm. As such, a systematic literature review of research based in the UK and Ireland spanning 2008-2020 was conducted. A narrative synthesis identified three themes: ‘Increases in self-harm rates from 2008’, ‘Economic Distress’, and ‘Support’. Findings highlight that increases in rates of self-harm could be understood in the context of austerity and point to support prioritising social issues, with clear service pathways as well as addressing need associated with contextual vulnerabilities.
The empirical study explores the experiences of CAMHS practitioners through hearing the stories and meanings they have generated from their experiences of working with young people who self-harm. Nine clinicians from across four CAMHS services in England took part in non- directive interviews. Narrative analysis found distinctions between experiences clinicians faced in relation to themselves as individuals and challenges associated with wider systems. Key challenges faced by clinicians suggest the need for a cultural shift in how we make sense of distress with corresponding changes to service design and provision.

Publisher
Department of Psychological Health, Wellbeing and Social Work, The University of Hull
Supervisor
Schlösser, Annette; Walton, Paul
Qualification level
Doctoral
Qualification name
ClinPsyD
Language
English
Extent
1 MB
Identifier
hull:18445
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