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“There is so much more for us to lose if we were to kill ourselves”: understanding paradoxically low rates of self-harm in a socioeconomically disadvantaged community in London.

Research output: Contribution to journalArticlepeer-review

Original languageEnglish
Pages (from-to)122-136
Number of pages15
JournalQualitative Health Research
Volume31
Issue number1
DOIs
Accepted/In press19 Aug 2020
PublishedJan 2021

Bibliographical note

Funding Information: The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: C.P. is funded by a Wellcome Trust Research Training Fellowship (Reference 105757/Z/14/Z). This paper represents independent research part funded by the National Institute for Health Research (NIHR) Biomedical Research Center at South London and Maudsley NHS Foundation Trust and King?s College London and the ESRC Center for Society and Mental Health at King?s College London (ESRC Reference: ES/S012567/1). The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, the Department of Health and Social Care, the ESRC, or King?s College London. Funders had no role in the study design or execution or decision to submit for publication. Funding Information: The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: C.P. is funded by a Wellcome Trust Research Training Fellowship (Reference 105757/Z/14/Z). This paper represents independent research part funded by the National Institute for Health Research (NIHR) Biomedical Research Center at South London and Maudsley NHS Foundation Trust and King’s College London and the ESRC Center for Society and Mental Health at King’s College London (ESRC Reference: ES/S012567/1). The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, the Department of Health and Social Care, the ESRC, or King’s College London. Funders had no role in the study design or execution or decision to submit for publication. Publisher Copyright: © The Author(s) 2020. Copyright: Copyright 2020 Elsevier B.V., All rights reserved.

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  • QHR second revision unblinded submission

    QHR_second_revision_unblinded_submission.docx, 184 KB, application/vnd.openxmlformats-officedocument.wordprocessingml.document

    Uploaded date:04 Sep 2020

    Version:Accepted author manuscript

King's Authors

Abstract

London has unexpectedly low overall rates of self-harm in public health data and contains highly deprived areas with these paradoxically low rates. Qualitative data were collected via interviews and focus groups with 26 individuals living and working in one such area. Using the Stress Process Model, we explore why this ethnically diverse community, which is exposed to multiple, chronic stressors, might nonetheless appear to have low rates of self-harm. Participants described significant impacts of stressors on the mental health of people locally. These were partly buffered by social resources related to community solidarity and a culture of self-reliance. However, identifying oneself as mentally ill through being known to have self-harmed was seen as highly risky, diminishing a person’s social status and exposing them to additional stressors from the community and services. Consequently, people tended to hide distress, respond with behaviors less linked to mental illness and avoid mental health services.

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