Staff beliefs towards self-injurious behaviour in patients: A study of secure services

Abstract

Staff beliefs towards patient self-harm in secure forensic services are explored, capturing forensic nurses and other clinical staff from four secure units from one NHS Trust, comprising high through to low and forensic learning disability. One hundred and fifty-five respondents took part (overall completion rate 61%). The Theory-driven Measure of Self-Injurious Behaviour and the Suicide Competency Assessment Form were completed. It was predicted that higher competency and increased levels of training would associate with beliefs towards patient self-harm. Beliefs differed in accordance to location; perceiving self-injurious behaviour as planned and within patient control was endorsed more in high security settings, by forensic nurses, with nurses in high security also more likely to endorse the perception that patients engaging in such behaviour were able to cope and felt valued. Competence and training experience were identified as factors of relevance. The study offers suggestions for future research, including a focus on capturing the environment, exploring ‘endorsed beliefs’ as opposed to ‘negative attitudes’, and proposing the concept of ‘professional exposure to self-harm’ as an important variable.