Research Article| Volume 20, ISSUE 4, P186-192, August 2006

Understanding Psychiatric Nursing Care with Nonsuicidal Self-Harming Patients in Acute Psychiatric Admission Units: The Views of Psychiatric Nurses

  • Áine O’Donovan
    Address reprint requests to Áine O Donovan, RPN, BNS (Hons), MSc, Lecturer Practitioner, Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland.
    Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland
    Search for articles by this author
  • Harry Gijbels
    Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland
    Search for articles by this author
      Self-harm in the absence of suicidal intent is an underexplored area in psychiatric nursing research. This article reports on findings of a study undertaken in two acute psychiatric admission units in Ireland. The purpose of this study was to gain an understanding of the practices of psychiatric nurses in relation to people who self-harm but who are not considered suicidal. Semistructured interviews were held with eight psychiatric nurses. Content analysis revealed several themes, some of which will be presented and discussed in this article, namely, the participants' understanding of self-harm, their approach to care, and factors in the acute psychiatric admission setting, which impacted on their care. Recommendations for further research are offered.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Archives of Psychiatric Nursing
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Allen J.
        • Williamson S.
        • Gatford C.
        • Worthington A.
        Deliberate self-harm: Developing clinical guidelines.
        Nursing Standard. 1997; 12: 34-37
        • American Psychiatric Association
        Diagnostic and statistical manual of mental disorders.
        4th ed. American Psychiatric Association, Washington, DC1994
        • Batt A.
        • Eudier F.
        • Le Vaou P.
        • Breurec J.
        • Baert A.
        • Curtes J.
        • et al.
        Repetition of parasuicide: Risk factors in general hospital referred patients.
        Journal of Mental Health. 1998; 7: 285-297
        • Burrow
        The deliberate self harming behaviour of patients within a British special hospital.
        Journal of Advanced Nursing. 1992; 17: 138-148
        • Bywaters P.
        • Rolfe A.
        Looking beyond the scars. Understanding and responding to self injury and self harm.
        NCH, London2002
        • Cook J.
        With serious intent: A review of the literature on non-fatal deliberate self harm.
        Mental Health Care. 1999; 3: 177-185
        • DeSantis L.
        • Ugarriza D.
        The concept of theme as used in qualitative nursing research.
        Western Journal of Nursing Research. 2000; 22: 351-372
        • Dunleavy R.
        An adequate response to a cry for help? Parasuicide patient's perceptions of their nursing care.
        Professional Nurse. 1992; 5: 213-215
        • Fletcher R.
        The process of constant observation: Perspectives of staff and suicidal patients.
        Journal of Psychiatric and Mental Health Nursing. 1999; 6: 9-14
        • Gallop R.
        • Tully T.
        The person who self-harms.
        in: Barker P. Psychiatric and mental health nursing. The craft of caring. Arnold, London2003: 236-243
        • Graham I.
        Seeking clarification of meaning: A phenomenological interpretation of the craft of mental health nursing.
        Journal of Psychiatric and Mental Health Nursing. 2001; 8: 335-345
        • Greenwood S.
        • Bradley P.
        Managing deliberate self harm: The A&E perspective.
        Accident and Emergency Nursing. 1997; 5: 134-136
        • Harris J.
        Self harm: Cutting the bad out of me.
        Qualitative Health Research. 2000; 10: 164-173
        • Holloway I.
        • Wheeler S.
        Qualitative research for nurses.
        Blackwell Science, Oxford1996
        • Hummelvoll J.K.
        • Severinsson E.I.
        Imperative ideals and the strenuous reality: Focusing on acute psychiatry.
        Journal of Psychiatric and Mental Health Nursing. 2001; 8: 17-24
        • Kreitman N.
        • Philip A.
        • Greer S.
        • Bagley C.
        British Journal of Psychiatry. 1969; 115: 746-747
        • Lindars J.
        Holistic care in parasuicide.
        Nursing Times. 1991; 87: 30-31
        • Long D.
        • Reid S.
        An exploration of nurses attitudes to the nursing care of the suicidal patient in an acute psychiatric ward.
        Journal of Psychiatric and Mental Health Nursing. 1996; 3: 29-37
        • McAllister M.
        Multiple meanings of self harm: A critical review.
        International Journal of Mental Health Nursing. 2003; 12: 177-185
        • McKenna H.
        The role of reflection in the development of practice theory: A case study.
        Journal of Psychiatric and Mental Health Nursing. 1999; 6: 147-151
        • McLaughlin C.
        An exploration of psychiatric nurses and patients opinions regarding inpatient care for suicidal patients.
        Journal of Advanced Nursing. 1999; 29: 1042-1051
        • Morgan H.
        The urban distribution of non-fatal deliberate self harm.
        British Journal of Psychiatry. 1975; 126: 319-326
        • National Institute of Clinical Excellence
        Self harm. The short term physical and psychological management and secondary prevention of self harm in primary and secondary care.
        Stanley Hunt Ltd., Northhamptonshire2004
        • Oxford English Dictionary
        Compact Oxford English dictionary.
        2nd ed. Oxford University Press, Oxford2003
        • Pembroke L.
        Self harm. Perspectives from personal experience.
        Survivors Speak Out, London1996
        • Pembroke L.
        Self-harm: A personal story.
        Mental Health Practice. 1998; 2: 20-24
        • Polit D.
        • Beck C.
        • Hungler B.
        Essentials of nursing research methods appraisal and utilization.
        5th ed. Lippincott, Philadelphia2001
        • Severenisson E.
        • Hummelvoll J.
        Factors influencing job satisfaction and ethical dilemmas in acute psychiatric care.
        Nursing and Health Science. 2001; 3: 81-90
        • Smith S.E.
        Perceptions of service provision for clients who self-injure in the absence of expressed suicidal intent.
        Journal of Psychiatric and Mental Health Nursing. 2002; 9: 595-601
        • The National Inquiry into Self Harm Among Young People. Self Harm Definition
        (22nd Feb 2005)
        • Warm A.
        • Murray C.
        • Fox J.
        Who helps? Supporting people who self-harm.
        Journal of Mental Health. 2002; 11: 121-130
        • Welsh I.
        • Lyons C.
        Evidence-based care and the case for intuition and tacit knowledge in clinical assessment and decision making in mental health nursing practice: An empirical contribution to the debate.
        Journal of Psychiatric and Mental Health Nursing. 2001; 8: 299-305
        • World Health Organization
        The ICD-10 classification of mental and behavioural disorders.
        World Health Organization, Geneva1992
        • World Health Organization
        For which strategies of suicide prevention is there evidence of effectiveness.
        World Health Organization, Copenhagen2004