Harm-reduction approaches for self-cutting in inpatient mental health settings:development and preliminary validation of the Attitudes to Self-cutting Management (ASc-Me) Scale

IntroductionHarm-reduction approaches for self-harm in mental health settings have been under-researched.AimTo develop a measure of the acceptability of management approaches for self-cutting in mental health inpatient settings.MethodsStage one: scale items were generated from relevant literature and staff/service user consultation. Stage two: A cross-sectional survey and statistical methods from classical test theory informed scale development.Results/FindingsAt stage one N=27 staff and service users participated. At stage two N=215 people (n=175 current mental health practitioners and n=40 people with experience of self-cutting as a UK mental health inpatient) completed surveys. Principal components analysis revealed a simple factor structure such that each method had a unique acceptability profile. Reliability, construct validity, and internal consistency were acceptable. The harm-reduction approaches 'advising on wound-care' and 'providing a first aid kit' were broadly endorsed; 'providing sterile razors' and 'maintaining a supportive nursing presence during cutting' were less acceptable but more so than seclusion and restraint.DiscussionThe Attitudes to Self-cutting Management scale is a reliable and valid measure that could inform service design and development.Implications for practiceNurses should discuss different options for management of self-cutting with service users. Harm reduction approaches may be more acceptable than coercive measures. This article is protected by copyright. All rights reserved.</p

STILL HERE : RECLAIMING TRADITIONAL SAMI KNOWLEDGE THROUGH A COMPETENCE CENTRE

A couple of years ago, I received a Sami drinking vessel called “goksie” (in umesamiska) from my dad. The fact that it was my grandmother’s who had crafted it some time around the 70’s was news to me. The goksie has been closely investigated as a part of this thesis and a way for me to reconnect with the Sami culture. The more I learned during this investigation the more I considered to follow my grandmother’s footsteps exploring and crafting my own goksie and reclaiming knowledge through the process of making. Through this journey, questions about architecture and cultural identity evolved.Due to the degrading views of Sami culture that many generations have experienced in the history, a lot of Sami cut ties with their background. The colonization of Sápmi have contributed to the loss of Sami culture in different ways. Except from appropriating the land that the Sami used, the Swedish state split the Sami people by deciding who was the “real” and “authentic” Sami and who wasn’t. The Sami was considered racially inferior predestined only for reindeer herding. It becomes clear that the colonization affected generations like my grandmother when realizing that the consequences can be traced all the way to myself not having the knowledge to create my own goksie or the cultural heritage of speaking Sami. Being Sami today can therefore, from my perspective, relate to a feeling of loss and a fragmented identity. Except reconnecting with my own Sami heritage, the making of the goksie has become a method for collaborative work creating relationships with newly discovered relatives and people from the Sami community. Interviews with Sami and non-Sami operators working on different national levels and with different issues has also been an important method to gather information. The methodologies are based on the strategy of “digging were I stand” - a way to learn more about my own history and through that knowledge reveal stories and voices of others, adapt to the needs and aspiration of the community, break free from stereotypes and simplified images about the cultural community and to always be critical are some of the guidelines that have constituted the Preface7role of the architect within this project. It is difficult to find a wider discussion about Sami typology and architecture on the Swedish side of Sápmi, concerning both traditional and contemporary structures. The colonization has left marks even within contemporary architecture designed by non-Sami were the stereotype and romantic image of the culture becomes dominant. Is it enough to symbolize the Sami culture with simple forms and expressions or are there other values that enrich not only the Sami community but also the view of architecture? In order to give something back to the Sami community this thesis explores how to create a space were knowledge can be reclaimed and passed on, proposing a building located in Malå in the county of Västerbotten. The aim is to combine traditional Sami building techniques with modern and contemporary solutions as well as to reflect on the typology of the South Sami kåta, the nomadic lifestyle and trying to understand the full complexity of Sami building traditions. In a wider context, the Sami Competence centre aims to ensure that the integrity of traditional Sami knowledge is maintained for generations to come

Meanings of caring for people who self-harm as disclosed in narratives of dialectical behaviour therapy professionals

Accessible summary This paper adds a phenomenological hermeneutic perspective on meanings of caring for adult people who self-harm as disclosed in narratives of dialectical behaviour therapy (DBT)-trained professionals. This paper shows that providing DBT care for people who self-harm means embarking an unpredictable journey, sometimes lonely, but also often together with the person who self-harm and with the DBT team. This paper emphasizes professionals' benefits of the tools and structure offered by DBT; however, the text points to the importance of the genuine meeting, including confirmation, as a prerequisite to recovery. This paper suggests that further research might focus on the meanings of genuine meetings and their organizational prerequisites. AbstractIn this paper, we aim to explore meanings of caring for adult people who self-harm as described in the narratives of professionals trained in dialectical behaviour therapy (DBT). We conducted narrative interviews with nine professionals working in a DBT team and used a phenomenological hermeneutical method to analyse their narratives. Our comprehensive understanding cast the caring relationship as an unpredictable journey, in which the professionals were guides or companions who aimed to walk side-by-side with the person who self-harms, prove to be trustworthy, and keep on track. They sometimes saw the journey as lonely and sometimes as a joint endeavour. Our analysis was informed by Martin Buber's writings on the genuine meeting' and confirmation. The professionals emphasized the importance of the tools and structure offered by DBT; however, the text points to the importance of the genuine meeting, including confirmation, as a prerequisite to recovery. Mental health nurses need opportunities for continuous training and counselling.</p