Experiences of pre-registration mental health nursing students who witness self-injury amongst service users during placement: a cross-sectional study

Mental health nursing (MHN) students will witness self-harm and self-injury (SHSI); however, little is known regarding the experience of MHN students who witness SHSI whilst on placement. The study aimed to understand the personal impact of SHSI upon mental health nursing students on placement with four objectives: 1. To identify the types of self-harm and self-injury (SHSI) witnessed by mental health nursing students; To evaluate MHN students’ perceived self-competence in working with service users who have self-harmed and self-injured; 3. To appraise the access to support and types of support required by mental health nursing students; 4. To assess the potential psychological trauma upon mental health nursing students of witnessing self-harm and self-injury. A cross-sectional questionnaire comprising researcher-generated Likert-style items, a validated trauma scale, and open-ended response questions was utilised. Descriptive analysis was completed of 84 responses from MHN students. The types of SHSI witnessed included cutting (65 participants; 77.4%); head-banging / punching (62 participants; 73.8%) and ligation (36 participants; 42.9%). Factors contributing toward SHSI and that helped students learn from and cope with incidents was evident. Three themes emerged from analysis of open-ended responses: Resilience on placement; Sources of stress; Sources of Support. Key findings were: (i) student nurses need to be prepared witnessing of an SHSI incident, including how to respond compassionately, emotionally and professionally pre and post event; (ii) student experience of SHSI; and, (iii) registered nurse response requires further investigation. A joined-up approach from University and practice partners is needed to address these issues.