Table 5 Reported Reasons for Self-harm (by year of publication)

Sefa-Dedeh & Canetto

(1992) [22]

Ghana

Attempted suicide

General Hospital.

Qualitative clinical case study of clinical records.

(Two cases: Only Case A included in review).

To:

▪ Die

▪ Validate self

To:

▪ Get revenge against parents

▪ Make parents feel guilty;

▪ Obtain empathy and understanding from family.

▪ Regain control over social relationships and resources.

Wassenaar et al.

(1998) [23]

South Africa

Attempted suicide

General Hospital.

Qualitative clinical case study of clinical records.

(Three cases: Only Case 2 included in review).

To die

To resolve conflict with parents.

Mhlongo & Peltzer

(1999) [88]

South Africa

Parasuicide

General hospital.

Patients’ records and interviews with patients presenting with self-harm.

(n = 100)

To die (27 [27%])

To demonstrate, usually, against family conflicts and abuse (58 [58%])

Beekrum et al.

(2011) [24]

South Africa

Non-fatal suicidal behaviour

General hospital.

Qualitative case study.

(n = 10)

To: ^c

▪ Stop feelings of hopelessness and despair.

▪ Get rid of negative thoughts.

To: ^c

▪ Let others (e.g., boyfriend, or parent) change their behaviour or attitudes.

▪ Communicate distress related to conflict with parents, parental conflict, high parental expectations, and peer-cultural conflict.

▪ Get parents/family to understand their problems.

Pretorius

(2011) [29]

South Africa

Deliberate self-harm

Children’s homes.

Mixed methods approach.

(n = 12)

To:

▪ Stop bad feelings (8 [66.6%])

▪ Feel relaxed (7 [58.3%])

▪ Feel something, even if it was pain (7 [58.3%])

▪ Punish self (5 [41.6%])

▪ Relieve feeling ‘numb’/empty (5 [41.6%])

To:

▪ Get control of a situation (5 [41.6%])

▪ Receive more attention from guardians /caregivers/ friends (2 [16.6%])

▪ Get guardians/caregivers to understand you (2 [16.6%])

▪ Get help (1 [8.3%])

van Rooyen

(2013) [50]

South Africa

Deliberate self-harm

University.

Cross-sectional survey of students.

(n = 603)

To: ^c

▪ Stop bad feeling

▪ Relieve feeling numb or empty

▪ Punish yourself

▪ Feel relaxed

▪ Get control of a situation

▪ Feel part of a group

▪ Be like someone you respect

▪ Avoid having to do something unpleasant you don’t want to do

To: ^c

▪ Let others know how desperate you were

▪ Try to get a reaction from someone, even if it’s a negative reaction

▪ Receive more attention from your parents or friends

▪ Get your parents to understand or notice you

▪ Get other people to act differently or change

▪ Avoid school, work, or other activities

▪ Avoid being with people

Meissner & Bantjes (2017) [27]

South Africa

Attempted suicide

University.

One-to-one semi-structured qualitative interviews with students with histories of attempted suicide.

(n = 4)

To: ^c

▪ Escape feeling trapped

▪ Avoid suicide

▪ Distract from painful memories

▪ Die

To: ^c

▪ Make emotional pain visible to others

▪ Disconnect from others

Kritzinger

(2018) [26]

South Africa

Non-Fatal Suicidal Behaviour

General hospital.

Qualitative case study approach: One-to-one semi-structured interviews with clinical sample of adolescents.

(n = 10)

To: ^c

▪ Escape unbearable thoughts

▪ End sense of meaninglessness

▪ Die

To: ^c

▪ Escape a painful/unbearable situation

▪ Make parents change their mind/behaviour.