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Understanding self-harm in older adults: a qualitative study

Troya, M. Isabela, Dikomitis, Lisa, Babatunde, Opeyemi O., Bartlam, Bernadette, Chew-Graham, Carolyn A. (2019) Understanding self-harm in older adults: a qualitative study. EClinicalMedicine, 12 . pp. 52-61. E-ISSN 2589-5370. (doi:10.1016/j.eclinm.2019.06.002) (KAR id:104589)



Self-harm is the leading risk factor for suicide, with elevated rates reported amongst older populations. This study explores how older adults experience self-harm, identifying factors leading to self-harm.


Semi-structured interviews with older adults (≥60 years) engaging in self-harm and support workers from third sector services in England. Older adults were invited to participate in a follow-up interview. Interviews were recorded, transcribed verbatim and data analysed thematically. Ethical approval obtained from Keele University's Ethics Review Panel. A Patient Involvement group contributed to study design, data analysis and interpretation.

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Between September 2017 to September 2018, 24 interviews were conducted involving 16 participants: nine older adults and seven support workers. Eight older adults consented to follow-up interviews. All older adults reported diagnoses of mental illness in addition to physical illness. Participants identified diverse stressors accumulating over the life-course leaving older adults particularly vulnerable to self-harm. Such stressors included adverse events, loss, interpersonal and health problems. A sense of shame and stigma amongst older people using self-harm to manage distress was also reported.


Self-harm is often concealed due to stigma and shame, being further accentuated amongst older adults, which may result in low levels of medical help-seeking behaviour for self-harm. Self-harm occurred along a spectrum of no-suicidal intent to high-levels of intent, suggesting self-harm holds different functions to older adults. Clinicians should be aware of the existence of self-harm in this age-group, and the heightened risk amongst those with comorbidities so adequate assessment, support and/or referral is provided.

Item Type: Article
DOI/Identification number: 10.1016/j.eclinm.2019.06.002
Uncontrolled keywords: self-harm; qualitative; suicide; older adults
Subjects: R Medicine
Divisions: Divisions > Division of Natural Sciences > Kent and Medway Medical School
Funders: University of Kent (
Depositing User: Manfred Gschwandtner
Date Deposited: 11 Jan 2024 19:00 UTC
Last Modified: 12 Jan 2024 12:14 UTC
Resource URI: (The current URI for this page, for reference purposes)

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