Harm-reduction approaches for self-cutting in inpatient mental health settings: development and preliminary validation of the Attitudes to Self-cutting Management (ASc-Me) Scale

Leah Hosie, Geoffrey L Dickens

    Research output: Contribution to journalArticlepeer-review

    8 Citations (Scopus)
    343 Downloads (Pure)

    Abstract

    Introduction

    Harm-reduction approaches for self-harm in mental health settings have been under-researched.

    Aim

    To develop a measure of the acceptability of management approaches for self-cutting in mental health inpatient settings.

    Methods

    Stage one: scale items were generated from relevant literature and staff/service user consultation. Stage two: A cross-sectional survey and statistical methods from classical test theory informed scale development.

    Results/Findings

    At stage one N=27 staff and service users participated. At stage two N=215 people (n=175 current mental health practitioners and n=40 people with experience of self-cutting as a UK mental health inpatient) completed surveys. Principal components analysis revealed a simple factor structure such that each method had a unique acceptability profile. Reliability, construct validity, and internal consistency were acceptable. The harm-reduction approaches 'advising on wound-care' and 'providing a first aid kit' were broadly endorsed; 'providing sterile razors' and 'maintaining a supportive nursing presence during cutting' were less acceptable but more so than seclusion and restraint.

    Discussion

    The Attitudes to Self-cutting Management scale is a reliable and valid measure that could inform service design and development.

    Implications for practice

    Nurses should discuss different options for management of self-cutting with service users. Harm reduction approaches may be more acceptable than coercive measures. This article is protected by copyright. All rights reserved.

    Original languageEnglish
    Pages (from-to)531-545
    Number of pages15
    JournalJournal of Psychiatric and Mental Health Nursing
    Volume25
    Issue number9-10
    Early online date26 Sep 2018
    DOIs
    Publication statusPublished - 21 Dec 2018

    Keywords

    • Attitude
    • Harm reduction
    • Inpatients
    • Self-injurious behaviour
    • Surveys and questionnaires

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