An exploration of the lived experiences of people who self-harm in two secure/locked mental health hospitals in Ghana

Background An increasing number of people who Self-Harm (SH) are being treated in mental health hospitals globally and it is now considered a major health problem. Incidence of SH are common in secure hospitals with those who use SH being highly dependent on staff for care and support, impacting on often limited resources Whilst literature related to the lived experiences of people who SH and those caring for them in secure settings exists, this is in its infancy in African countries. The aim of this study was ‘to explore the lived experience and perceptions of people who Self-harm (SH) in two secure/locked mental health hospitals in Ghana. Method Interpretive Phenomenological Analysis informed a detailed exploration of experiences of people who self-harm in two separate secure mental hospitals in Ghana. A convenience sample of nine participants (two males and three females from one hospital and one male and three females from the other hospital) were recruited to the study. Face to face in-depth semi structured interviews were carried out with individual participants in in-patient settings. With the permission of each participant all interviews were audio recorded and each lasted approximately 60 – 90 minutes. Each interview was transcribed by the researcher and then analysed to identify subordinate and super-ordinate themes. Findings Four superordinate themes emerged from participants stories: Being let down; Living with the negative self; Forces of the supernatural and religion; and Living with the positive self. One of the interesting findings of this study is participants’ descriptions of their subjective assessment of spirituality, namely ’ghost of mental illness’, and how they attribute it to their self-harm and its possible treatment. This finding illuminates participants’ life world in the Ghanaian context, highlighting the implications for orthodox medicine and traditional/multifaith healers. Conclusion There is a need to develop collaborative health care package if appropriate care and support is to be offered to people in secure settings who use high-risk behaviours, such as self-harm. To ensure care is holistic, culturally and temporally relevant more research is needed, particularly in Sub-Saharan Africa