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Cutting through the Stigma: Exploring Community Attitudes Towards Self-Harm

Student Researchers: Ashleigh Hardcastle, Natalie Ball, Michael Butler and Kadie Krome
Supervisor: Dr Suzanne Dziurawiec
Ethics approval: 2013/089

Self-harm is a non-fatal act in which an individual engages in a behaviour, or ingests a harmful substance or object, with the intention of causing harm to themselves (Moran et al., 2012). Previous studies have found that self-harm is a growing problem in Australia, with approximately eight percent of the population engaging in the behaviour during their lifetime (Moran et al.). It is important to understand how self-harm is perceived in the community, as it has been found that negative attitudes may prevent people who self-harm from seeking help (Kholodkov, 2011).

While many studies have focused on the attitudes of nurses and mental health staff, and several on teachers and parents, few have examined attitudes towards self-harm in the general community. Those which have focused on community attitudes have typically used a very small sample or a sample consisting entirely of students, which limits the generalizability of their findings.

The current study aimed to gauge the general public’s level of understanding regarding the reasons why people self-harm, their attitudes towards individuals who engage in the behaviour, and whether understandings and attitudes vary according to specific demographic factors and previous contact with self-harm.

Method

Two hundred and nineteen members of the general community took part in the study, with approximately 80% of the sample consisting of females and nearly 50% of participants aged 24 or under. The majority of participants reported having known someone who had self-harmed, with nearly two thirds of the sample reporting having known at least two such individuals.

The current study was advertised via Facebook and posters, and was open to all members of the general public aged 18 or over. Participation in the study involved completing a 20 minute, anonymous, web-based survey, in which participants were asked to rate their level of agreement with statements regarding possible motivations for self-harm, as well as statements regarding individuals who self-harm.

Results

Results indicated that the general community has a good level of understanding regarding the functions of self-harm, and, overall, attitudes were fairly positive. Participants who had a greater number of self-harm contacts and those with a higher level of closeness to an individual who had self-harmed demonstrated greater understanding of self-harm than those with fewer and less close contacts. Greater understanding, in turn, was associated with more positive attitudes towards those who had self-harmed. While number of self-harm contacts was weakly associated with attitudes, level of closeness showed no association with attitudes. Age, gender, level of education, and urban versus rural location were not found to be associated with either understanding of or attitudes towards self-harm.

Discussion

The finding that the general community has a good understanding of the motivations for self-harm may be partially explained by the fact that portrayals of self-harm in popular media, which have been found to be fairly accurate, have increased in recent years (Trewavas, Hasking, & McAllister, 2010). The finding that attitudes were generally positive is optimistic, and is in line with the findings of previous community studies. However, because the study was explicitly advertised as exploring attitudes towards self-harm, it is likely that many people who responded to the survey had a prior interest in the subject and were therefore likely to have had more positive attitudes than those who chose not to take part. Greater understanding was also found to be associated with more positive attitudes, and it is suggested that this may be due, in part, to challenging the misconception that self-harming is a form of attention-seeking, as previous studies have found this idea of attention-seeking to be at the heart of negative attitudes towards those who self-harm (Scourfield, Roen, & McDermott, 2011).

The finding that knowing a greater number of individuals who had self-harmed was associated with having a greater understanding of the reasons people self-harm and weakly associated with having a more positive attitude has implications for reducing the stigma surrounding self-harm. Specifically, it is suggested that involving a lived-experience speaker in self-harm education and training programs may be useful. In addition, while the finding that having a closer relationship with a person who had self-harmed was associated with greater understanding suggests that longer, face-to-face contact may be optimal, it is suggested that future studies examine the extent to which the effects of contact can be extended to situations in which contact is brief, or perhaps even presented in digital format.

References

Kholodkov, T. (2011). Stigmatization as a barrier to help-seeking among individuals who engage in non-suicidal self-injury (Master’s Thesis). Available from ProQuest Dissertations and Theses database. (Document ID: 875891758)

Moran, P., Coffey, C., Romaniuk, H., Olsson, C., Borschmann, R., Carlin, J. B., & Patton, G. C. (2012). The natural history of self-harm from adolescence to young adulthood: A population-based cohort study. The Lancet, 379, 236-243. doi:10.1016/S0140-6736(11)61141-0

Scourfield, J., Roen, K., & McDermott, E. (2011). The non‐display of authentic distress: Public‐private dualism in young people’s discursive construction of self‐harm. Sociology of Health and Illness, 33, 777-791. doi:10.1111/j.1467-9566.2010.01322.x

Trewavas, C., Hasking, P., & McAllister, M. (2010). Representations of non-suicidal self-injury in motion pictures. Archives of Suicide Research, 14, 89–103. doi:10.1080/13811110903479110