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

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.

Digital access constraints predict worse mental health among adolescents during COVID-19

The COVID-19 pandemic and ensuing social restrictions disrupted young people's social interactions and resulted in several periods during which school closures necessitated online learning. We hypothesised that digitally excluded young people would demonstrate greater deterioration in their mental health than their digitally connected peers during this time. We analysed representative mental health data from a sample of UK 10-15-year-olds (N = 1387) who completed a mental health inventory in 2017-2019 and thrice during the pandemic (July 2020, November 2020 and March 2021). We employed longitudinal modelling to describe trajectories of adolescent mental health for participants with and without access to a computer or a good internet connection for schoolwork. Adolescent mental health symptoms rose early in the COVID-19 pandemic, with the highest mean Total Difficulties score around December 2020. The worsening and subsequent recovery of mental health during the pandemic was greatly pronounced among those without access to a computer, although we did not find evidence for a similar effect among those without a good internet connection. We conclude that lack of access to a computer is a tractable risk factor that likely compounds other adversities facing children and young people during periods of social isolation or educational disruption.

Lessons from a review of physiotherapy and psychological rehabilitation received during ICU stay and beyond to inform the development of an ICU follow clinic

BACKGROUND

Critical illness can have a long-term impact. A service evaluation was conducted in a hospital in the south west of Britain with an adult inter-connected general, surgical and neurological intensive care unit (ICU). The aim of the service evaluation was to generate knowledge on experiences of psychological and physical rehabilitation in intensive care, on other hospital wards and at home to inform the development of an Intensive Care follow up clinic.

METHOD

Data was collected from two sources. A week of ICU discharges was randomly selected, and a sample of 30 patients generated. All were sent information sheets and consent forms and offered telephone appointments. 12 participants took part in telephone interviews. The second source of participants was the ICU Expert by Experience group. Informed consent was gained with eight participants taking part. The data was analysed using thematic analysis, employing initial open coding to build a framework of emergent themes. A research group was formed to facilitate cross coding of extracts.

RESULTS

The analysis identified three overarching themes: sense making difficulties; rehabilitation context; and sense of self. The theme of sense making difficulties had sub-themes of memory gaps, delirium, lack of information and anxiety. The theme of rehabilitation context had sub-themes of ICU environment, transitions, isolation and abandonment and valued support.

CONCLUSION

the process of sense making can be difficult, is filtered through contextual factors, and may influence sense of self. The results have been used to inform the development of an ICU follow up clinic.

Does Emotional Arousal Influence Swearing Fluency?

This study assessed the effect of experimentally manipulated emotional arousal on swearing fluency. We hypothesised that swear word generation would be increased with raised emotional arousal. The emotional arousal of 60 participants was manipulated by having them play a first-person shooter video game or, as a control, a golf video game, in a randomised order. A behavioural measure of swearing fluency based on the Controlled Oral Word Association Test was employed. Successful experimental manipulation was indicated by raised State Hostility Questionnaire scores after playing the shooter game. Swearing fluency was significantly greater after playing the shooter game compared with the golf game. Validity of the swearing fluency task was demonstrated via positive correlations with self-reported swearing fluency and daily swearing frequency. In certain instances swearing may represent a form of emotional expression. This finding will inform debates around the acceptability of using taboo language.