Intended for healthcare professionals


Understanding resolution of deliberate self harm: qualitative interview study of patients' experiences

BMJ 2005; 330 doi: (Published 12 May 2005) Cite this as: BMJ 2005;330:1112
  1. Julia Sinclair, MRC special training fellow in health service research (julia.sinclair{at},
  2. Judith Green, senior lecturer2
  1. 1 Centre for Suicide Research, University Department of Psychiatry, Warneford Hospital, Oxford OX3 7JX,
  2. 2 Health Services Research Unit, London School of Hygiene and Tropical Medicine, London WC1E 7HT
  1. Correspondence to: J Sinclair
  • Accepted 22 March 2005


ObjectiveTo explore the accounts of those with a history of deliberate self harm but who no longer do so, to understand how they perceive this resolution and to identify potential implications for provision of health services.

Design Qualitative in-depth interview study.

Setting Interviews in a community setting.

Participants 20 participants selected from a representative cohort identified in 1997 after an episode of deliberate self poisoning that resulted in hospital treatment. Participants were included if they had no further episodes for at least two years before interview.

Results We identified three recurrent themes: the resolution of adolescent distress; the recognition of the role of alcohol as a precipitating and maintaining factor in self harm; and the understanding of deliberate self harm as a symptom of untreated or unrecognised illness.

Conclusion Patients with a history of deliberate self harm who no longer harm themselves talk about their experiences in terms of lack of control over their lives, either through alcohol dependence, untreated depression, or, in adolescents, uncertainty within their family relationships. Hospital management of deliberate self harm has a role in the identification and treatment of depression and alcohol misuse, although in adolescents such interventions may be less appropriate.


  • Contributors JS carried out the interviews, analysed the transcripts, and discussed the emerging coding schemes and decisions with JG. JS is guarantor.

  • Funding This study was funded as part of the MRC Training Fellowship held by JS.

  • Competing interests None declared.

  • Ethics approval Oxford Psychiatric Research ethics committee and the London School of Hygiene and Tropical Medicine ethics committee.

  • Accepted 22 March 2005
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