'Am I really the priority here?': help-seeking experiences of university students who self-harmed

Tickell, Alice; Fonagy, Peter; Hajdú, Katalin; Obradović, Sandra and Pilling, Stephen (2024). 'Am I really the priority here?': help-seeking experiences of university students who self-harmed. BJPsych Open, 10(2) (early access).

DOI: https://doi.org/10.1192/bjo.2023.652

Abstract

Background
Self-harm is a significant problem in university students because of its association with emotional distress, physical harm, broader mental health issues and potential suicidality. Research suggests that fewer than half of students who have self-harmed seek professional help when at university.
Aims
This study aimed to explore the help-seeking journeys of university students who had engaged in self-harm, to identify perceived facilitators and barriers to securing both formal and informal support.
Method
Participants comprised 12 students who had self-harmed during their university tenure. Engaging in two semi-structured interviews over the academic year, they shared insights into their help-seeking behaviours and proposed enhancements to local services. Data underwent reflexive thematic analysis within a critical realist framework.
Results
The analysis identified four themes: ‘The initial university phase poses the greatest challenge’, ‘Perceived criteria for “valid” mental health problems’, ‘Evading external judgements, concerns and consequences’ and ‘The pivotal role of treatment options and flexibility in recovery’.
Conclusions
Students felt isolated and misunderstood, which amplified self-harming tendencies and diminished inclinations for help-seeking. A prevalent belief was that for self-harm to be deemed ‘valid’, it must manifest with a certain severity; however, concurrent fears existed around the ramifications of perceived excessive severity. Participants expressed a desire for streamlined pathways to mental health resources, encompassing both university and external mental health services. Insights from this study could guide future research and inform current service paradigms within academic and healthcare systems.

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