Pre-registration mental health nursing students who witness self-harm amongst service users during placement: a cross-sectional study

Mental health nursing (MHN) students may witness self-harm on placements; however, little is known regarding the experience of MHN students who do witness this. This study aimed to understand the personal impact of witnessing self-harm events upon MHN students who are on placement, with three objectives: 1. To identify the types of self-harm witnessed by MHN students; 2. To evaluate MHN students’ perceived self-competence in working with service users who have self-harmed; and 3. To assess the potential psychological trauma upon MHN students after witnessing self-harm. A cross-sectional questionnaire comprising researcher generated Likert-style items, and open-ended response questions was utilised. Descriptive analysis was completed of 84 responses from MHN students. The types of self-harm witnessed included cutting (65 participants; 77.4%); head-banging / punching (62 participants; 73.8%) and ligation (36 participants; 42.9%). Additionally, we identified factors that either hindered or aided the MHN students in developing resilience post witnessing self-harm. These findings are presented as three qualitative themes, and are: resilience; sources of stress and sources of support. Key findings were: (i) current MHN students can experience a range of negative outcomes after witnessing a self-harm incident which can include wanting to withdraw from studies. (ii) Student experience of witnessing self-harm needs to be better understood and responded to. Finally, (iii) Universities and placement providers should deliver relevant training, with trauma informed care (TIC) pedagogy potentially being an effective intervention. Ultimately, we recommend a joined-up approach from Universities and practice partners to address these issues.