Patients’ experiences of emergency hospital care following self-harm: Systematic review and thematic synthesis of qualitative research

Rates of hospital presentation for self-harm have increased in recent years and although clinical practice guidelines on clinical provision prioritise positive patient experiences, the quality of provision remains variable. This systematic review provides an updated and extended synthesis of qualitative research on: i) patients’ experiences of treatment following presentation to hospital; and ii) patients’ perceptions of the impact of treatment on recurrent self-harm and/or suicidal ideation, and future help-seeking. 26 studies were identified for inclusion in the final synthesis. Three meta-themes emerged: i) individuals undertake extensive identity work when presenting with self-harm, navigating the process of becoming a patient and negotiating the type of patient they want to be; ii) care ranges from gentle to hostile, with care at admission and discharge being particularly disorientating and iii) negative experiences of clinical treatment may increase future self-harm. Emerging research gaps include the need for further theoretically-informed qualitative research in this area