Young people’s experiences of self-harm and suicide support through schools and youth organisations: A qualitative study in England

<p>Background: Self-harm and suicidal behaviour (SH&amp;amp;S) among young people (YP) aged 14–21 is a major public health concern. When YP disclose SH&amp;amp;S to adults, it is often those with whom they have ongoing trusted relationships, such as staff in schools and youth organisations. Experiences of accessing and receiving support in these settings are poorly understood. Objective: To explore the experiences of accessing and receiving support for SH&amp;amp;S at school and youth organisations, for YP from varied backgrounds. Design: Qualitative study with a combination of interviews and focus groups. Setting and participants: 64 YP aged 14–21 across England, all with lived experience of SH&amp;amp;S. Semi-structured topic guides covered experiences of seeking and receiving support for SH&amp;amp;S. Framework analysis was used to generate themes. Results: YP had positive experiences where support was accessible, relatable, and flexible to fit individual needs. Education settings were widely perceived to play an important support role, and barriers to seeking help included concerns around privacy, confidentiality and lack of transparency and choice in processes. Youth organisations could be perceived as an unsuitable place to seek support. However, organisations centred on identity or lived experiences were often important for building trusted relationships whereby SH&amp;amp;S could be disclosed. Conclusions: Creating organisational cultures that tackle SH&amp;amp;S stigma, supported by appropriate resources and founded on positive relationships and clear communication is crucial. While YP identified key elements of existing SH&amp;amp;S support in practice, further research could explore whether reported barriers and facilitators relate to differential effectiveness of prevention and intervention.</p>