{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T05:51:10Z","timestamp":1790142670052,"version":"4.0.1"},"reference-count":31,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2015,12,15]]},"published-print":{"date-parts":[[2016,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Self-harm and suicide increase in times of economic recession, but little is known about why people self-harm when in financial difficulty, and in what circumstances self-harm occurs. This study aimed to understand events and experiences leading to the episode of self-harm and to identify opportunities for prevention or mitigation of distress.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Participants\u2019 homes or university rooms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>19 people who had attended hospital following self-harm in two UK cities and who specifically cited job loss, economic hardship or the impact of austerity measures as a causal or contributory factor.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>Semistructured, in-depth interviews. Interviews were audio recorded, transcribed and analysed cross-sectionally and as case studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Study participants described experiences of severe economic hardship; being unable to find employment or losing jobs, debt, housing problems and benefit sanctions. In many cases problems accumulated and felt unresolvable. For others an event, such as a call from a debt collector or benefit change triggered the self-harm. Participants also reported other current or past difficulties, including abuse, neglect, bullying, domestic violence, mental health problems, relationship difficulties, bereavements and low self-esteem. These contributed to their sense of despair and worthlessness and increased their vulnerability to self-harm. Participants struggled to gain the practical help they felt they needed for their economic difficulties or therapeutic support that might have helped with their other co-existing or historically damaging experiences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Economic hardships resulting from the recession and austerity measures accumulated or acted as a \u2018final straw\u2019 to trigger self-harm, often in the context of co-existing or historically damaging life-experiences. Interventions to mitigate these effects should include providing practical advice about economic issues before difficulties become insurmountable and providing appropriate psychosocial support for vulnerable individuals.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2015-010131","type":"journal-article","created":{"date-parts":[[2016,2,18]],"date-time":"2016-02-18T10:12:39Z","timestamp":1455790359000},"page":"e010131","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":58,"title":["Understanding vulnerability to self-harm in times of economic hardship and austerity: a qualitative study"],"prefix":"10.1136","volume":"6","author":[{"given":"M C","family":"Barnes","sequence":"first","affiliation":[{"name":"School of Social and Community Medicine, University of Bristol, Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D","family":"Gunnell","sequence":"additional","affiliation":[{"name":"School of Social and Community Medicine, University of Bristol, Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R","family":"Davies","sequence":"additional","affiliation":[{"name":"School of Social and Community Medicine, University of Bristol, Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K","family":"Hawton","sequence":"additional","affiliation":[{"name":"Centre for Suicide Research, University of Oxford, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N","family":"Kapur","sequence":"additional","affiliation":[{"name":"Centre for Suicide Prevention, University of Manchester, Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Potokar","sequence":"additional","affiliation":[{"name":"School of Social and Community Medicine, University of Bristol, Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J L","family":"Donovan","sequence":"additional","affiliation":[{"name":"School of Social and Community Medicine, University of Bristol, Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2016,2,17]]},"reference":[{"key":"2025120518591326000_6.2.e010131.1","doi-asserted-by":"crossref","first-page":"243","DOI":"10.5498\/wjp.v5.i2.243","article-title":"Systematic review of suicide in economic recession","volume":"5","author":"Oyesanya","year":"2015","journal-title":"World J Psychiatry"},{"key":"2025120518591326000_6.2.e010131.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)61124-7"},{"key":"2025120518591326000_6.2.e010131.3","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.e5142"},{"key":"2025120518591326000_6.2.e010131.4","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.f5239"},{"key":"2025120518591326000_6.2.e010131.5","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1016\/j.socscimed.2014.07.024","article-title":"Suicide and the 2008 economic recession: who is most at risk? 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