People who self-harm: rapid evidence review and survey of practitioner perspectives

Conclusion

This research investigated whether self-harm acts as a barrier to accessing support and services, and what measures can be used to overcome these barriers. A rapid evidence review explored the barriers and facilitators to accessing and engaging with self-harm support, while the survey collected insights from practitioners who support people who self-harm across a broader range of services.

Findings from both the evidence review and practitioner survey highlight numerous barriers to accessing support for individuals who self-harm, including individual barriers such as fear of judgment and self-stigma, and service-level issues such as restrictive eligibility criteria and long waiting times.

A key contribution of this research is its focus on the potential barriers to accessing a broad range of support services. Findings suggest that distinct barriers may exist not only when seeking support for self-harm, but also for non-self-harm-related support such as housing, financial assistance, or education. These barriers can have significant mental health, physical health, and social implications.

Despite the multitude of barriers identified, both individuals with lived experience and practitioners reported a number of facilitators to overcoming them. These included adopting compassionate, person-centred approaches, improving service accessibility, and revising restrictive eligibility policies. Addressing these barriers requires creating inclusive, responsive support services that meet the diverse needs of people who self-harm.

Limitations

There were several limitations to the research. Firstly, because the survey focused on the perspectives of practitioners who support individuals who self-harm, it meant that the direct views of those with lived experience were not included. This limitation may be partly mitigated by the evidence review, which primarily included studies based on the lived experiences of individuals receiving support for their self-harm. Nonetheless, there is a lack of in-depth understanding about how individuals who self-harm experience barriers to a range of support services, extending beyond a healthcare setting.

Additionally, the survey was limited because specific barriers could not be attributed to specific support services due to the survey allowing respondents to select multiple options per question. The evidence review included studies from countries outside of Scotland. It is important to note that service provision may vary across different parts of the UK, including Scotland, which could affect how findings from other regions apply in the Scottish context.

Finally, the studies included in the review focused primarily on young people and women, highlighting a gap in understanding how barriers to accessing support and services — and their implications — may differ across population groups such as ethnicity, socioeconomic status, disability, sexual orientation, and religion. This underscores the need for further research to explore how individuals from diverse backgrounds experience these barriers and what can be done to address them across a broad range of support services.