Understanding Student Self-Harming Behaviours and The Spectrum of Care Within a University Context: A Mixed-Methods Approach

Young people present a high-risk group for engagement in self-harming behaviours, commonly associated with mental health difficulties and increased risk of suicide. University is a key period of transition for students, offering opportunities for personal and academic growth. However, managing the demands and responsibilities of university life can be overwhelming (Taliaferro & Muehlenkamp, 2015). Psychological distress may lead to engagement in self-harm as a means of coping (Stallman, 2020). Poorer outcomes in academic achievement, employability, and relationships have been reported among students who fail to receive support for their mental health. Resultantly, university has been highlighted as a crucial time point for psychological support (Holm-Hadulla & Koutsoukou-Argyraki, 2015). Despite this, research exploring self-harm within a UK university setting is lacking.

Study one consisted of two online questionnaires measuring self-harm alongside a series of psychosocial outcomes amongst current university students reporting lifetime self-harm, as well as those providing support to student self-harmers. Increased rates of alexithymia, emotional inhibition, and rumination, and reduced social contacts for students reporting lifetime self-harm were detected. Stigma and uncertainty regarding available support were common barriers to help-seeking at university. Further, the majority of those offering support to students who selfharm felt out of their depth and in need of their own support. Study two expanded on these findings with an in-depth qualitative exploration of student self-harm. Interviews revealed three key themes regarding the influence of university-specific factors on motivating, maintaining, and preventing self-harm. Whilst some reported difficulties with academic stressors, others felt that university was an opportunity for developing their identity and new relationships. Finally, study three presents the voice of those providing support for university students engaging in self-harm A broad spectrum of care in a university setting emerged, from professionals to friends and family members, including students with personal experiences of self-harm. Across all studies, the variation in supportive resources across UK universities was highlighted, with limited sessions and availability resulting in increased pressures on supporters and many students not accessing the care they need.

This body of research is unique in its understanding of self-harm from multiple perspectives and offers reflections from students who self-harm and those offering support. Novel insight into support provisions and help-seeking, as well as key triggers and maintenance factors of self-harm within a university context, is timely due to rising rates of poor mental health among students and demands on university support systems.