Experiences of Adults who Disclose Self-harm to Non-professionals

Background: Research suggests that self-harm is often a private behaviour and many individuals do not disclose their self-harm. People who feel unable to disclose their self-harm have less opportunity to seek support. There is a paucity of research on adult self-harm disclosure experiences, with most existing studies recruiting adolescents. Aims: This study aimed to understand the expectations and experiences of adults who self-harm when they disclose to non-professionals. Methods: Ten participants (aged 26-51) were recruited through the NHS and a third sector organisation. Semi-structured interviews were conducted and data was analysed using thematic analysis. Results: Four themes were identified; ‘The insular nature of self-harm’, ‘Imagined versus reality’, ‘Self-preservation’ and ‘New ways of relating’. Participants described self-harm as an insular behaviour, which created an inherent tension when considering disclosure; a social process. There were risks associated with self-harm disclosure, including stigma and losing control. Participants carefully considered the decision to disclose, experiencing high levels of ambivalence about disclosing and spending extended periods rehearsing potential disclosures. In reality, disclosure experiences were sometimes very different, with participants describing a range of positive and negative responses. Making such risky personal disclosures meant self-preservation was key, both during and after a disclosure. Participants found new ways of relating to their disclosure recipients and evaluated future potential disclosures depending on the response received. Most participants had experienced negative responses, which caused distress and curtailed future disclosures, highlighting a need for improved public awareness of supportive responses to disclosures of self-harm. Discussion: This study highlighted the personal risks and highly variable responses people experience when disclosing self-harm to a family member, friend or colleague. Helpful ways of responding to self-harm disclosures were highlighted by participants in this study and guidance could be published so that non-professionals can be informed and prepared for having conversations about self-harm.