From: Adolescent self-harm in Ghana: a qualitative interview-based study of first-hand accounts
Thematic area | Adolescent group | Theme | Brief explanation |
---|---|---|---|
1) Adolescents describe the background to self-harm | In-school | i. Powerlessness related to age and gender | ▪ Lack of power among young people and girls to take personal decisions and to contribute to or influence decisions and roles in the family. |
ii. Parental modelling and parent-child incongruent expectations | ▪ Conflicting role expectations between parents and their adolescent children. | ||
iii. Parental criticism | ▪ Criticism of adolescents by their parents. | ||
iv. Perceived unfair application of the rule of punishment | ▪ Perception that the rules governing punishment of deviant behaviours were unfairly or inconsistently applied by significant other adults (e.g., parents, older siblings etc.), leading to feeling unloved and uncared for. | ||
v. Perceived family mistrust and betrayal | ▪ False accusations and rumours where adolescents did not receive support and defence from their family. | ||
vi. Early adultification | ▪ The practice of making a child act as a primary caregiver providing emotional, material or instrumental support to adult relatives, younger siblings or to self, before the child is emotionally prepared to do so. | ||
vii. Diabolical control | ▪ Manipulations by unseen evil forces. | ||
Street-connected | i. Self-harm as a response to adultification in family of origin | ▪ The practice of making a child act as a primary caregiver providing emotional, material or instrumental support to adult relatives, younger siblings or to self, before the child is emotionally prepared to do so. | |
ii. Self-harm as a response to acculturative stress of street living | ▪ For newcomers to street living, self-harm was a response to the mental strain experienced in adapting to the harsh realities of street living. | ||
iii. Self-harm as a response to conflict of conduct norms in charity facility | ▪ For newcomers to charity facilities, self-harm was in response to the behavioural difficulty experienced in adapting to the controlled culture of charity facilities. | ||
2) Adolescents explain their self-harm | In-school: meaning-making | i. Enactment of tabooed emotions and contestations | ▪ A means of contesting or protesting unbearable scolding, criticism, and (perceived) abuse by their parents. |
ii. Avenge excessive control and punishment by parents | ▪ A means of avenging and ending the excessive control and punishment by their parents, particularly, fathers. | ||
iii. Responding to and management of negative emotions and circumstances | ▪ A way of managing acute negative emotions or as a response to emotional disturbance or negative (interpersonal) circumstances. | ||
In-school: consequences and influence on recovery | i. Self-harm as selfish act and social injury | ▪ Self-harm was personally helpful but socially injurious to significant others; this motivated stopping self-harm. | |
ii. Self-harm improves social relations | ▪ Self-harm led to improvement in social relationships with significant other adults; this motivated stopping self-harm. | ||
iii. Self-harm worsens abuse | ▪ Harsh punishment or abuse linked to self-harm worsened, particularly, where the self-harm was discovered because it resulted in hospitalisation. | ||
iv. Self-harm as religious transgression | ▪ A breach of religious tenets; this motivated stopping self-harm. | ||
Street-connected: explanatory accounts | i. Reliance on peer and surrogate family support | ▪ Adolescents relied on surrogate families and friends for financial and emotional support and protection; this motivated stopping self-harm. | |
ii. Reliance on charity support | ▪ Support obtained from attending charity facility helped street-connected adolescents in stopping or avoiding self-harm | ||
iii. Early adultification in the streets | ▪ Taking on the role of an adult to care and provide for one’s own needs motivated stopping self-harm. | ||
iv. Use of substitutes | ▪ Adolescents pursued (usually, harmful) alternative acts to distract themselves from self-harm (e.g., substance use). |