RT Article
T1 Walking a tightrope: ethical tensions in managing severe self-harm in a forensic mental health unit for young people
JF The journal of forensic psychiatry & psychology
VO 36
IS 2
SP 247
OP 263
A1 Johal, Harleen Kaur
A2 Kendall, Kathleen
A2 Adshead, Gwen 1960-
A2 Deshpande, Mayura
A2 Fenwick, Angela
LA English
YR 2025
UL https://krimdok.uni-tuebingen.de/Record/1920824022
AB While there is extensive research on how general mental health professionals respond to self-harm (SH) by adults, there is comparatively little research on the management of severe SH in forensic mental health settings for young people. This study aimed to explore how different professionals make decisions on managing SH in this population. A qualitative methodology was employed to investigate participants’ experiences. Focus groups were conducted with 14 professionals working in a UK medium-secure forensic mental health unit for young people, where severe SH is recurrent. Following the method of thematic analysis, two themes were identified. The first (‘walking a tightrope’) illustrates how professionals saw their role as allowing young people to make decisions within restrictive boundaries; how they negotiated ethical tensions between facilitating decision-making and intervening to prevent harm; and how this was perceived externally. The second theme (‘strategies employed’) describes professionals’ approaches to managing severe SH. Our findings add insight into how staff in forensic settings make complex ethical decisions, which are often concealed under the catch-all label of ‘clinical judgement’.
K1 Forensic psychiatry
K1 Mental Health
K1 Adolescent
K1 Young People
K1 Severe self-harm
DO 10.1080/14789949.2024.2428188