Adolescent self-harm in Ghana: a qualitative interview-based study of firsthand accounts

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dc.contributor.authorQuarshie, E.N-B.
dc.contributor.authorWaterman, M.G.
dc.contributor.authorHouse, A.O.
dc.date.accessioned2020-07-02T12:17:03Z
dc.date.available2020-07-02T12:17:03Z
dc.date.issued2020-06-01
dc.descriptionResearch Articleen_US
dc.description.abstractBackground: Recent prevalence studies suggest that self-harm among adolescents in sub-Saharan Africa is as common as it is in high income countries. However, very few qualitative studies exploring first-person accounts of adolescent self-harm are available from sub-Saharan Africa. We sought to explore the experiences and first-person perspectives of Ghanaian adolescents reporting self-harm - for deeper reflections on the interpretive repertoires available in their cultural context for making sense of self-harm in adolescents. Methods: Guided by a semi-structured interview protocol, we interviewed one-to-one 36 adolescents (24 in-school adolescents and 12 street-connected adolescents) on their experiences of self-harm. We applied experiential thematic analysis to the data. Results: Adolescents’ description of the background to their self-harm identified powerlessness in the family context and unwanted adultification in the family as key factors leading up to self-harm among both in-school and streetconnected adolescents. Adolescents’ explanatory accounts identified the contradictory role of adultification as a protective factor against self-harm among street-connected adolescents. Self-harm among in-school adolescents was identified as a means of “enactment of tabooed emotions and contestations”, as a “selfish act and social injury”, as “religious transgression”, while it was also seen as improving social relations. Conclusions: The first-person accounts of adolescents in this study implicate familial relational problems and interpersonal difficulties as proximally leading to self-harm in adolescents. Self-harm in adolescents is interpreted as an understandable response, and as a strong communicative signal in response to powerlessness and family relationship difficulties. These findings need to be taken into consideration in the planning of services in Ghana and are likely to be generalisable to many other countries in sub-Saharan Africa.en_US
dc.description.sponsorshipthe Leeds International Research Scholarship (LIRS) at the University of Leeds, School of Psychology, in the form of a doctoral scholarship to the first author (EQ) - [Grant №: CFN/sy/200631403].en_US
dc.identifier.citationQuarshie, E.N., Waterman, M.G. & House, A.O. Adolescent self-harm in Ghana: a qualitative interview-based study of first-hand accounts. BMC Psychiatry 20, 275 (2020). https://doi.org/10.1186/s12888-020-02599-9en_US
dc.identifier.otherhttps://doi.org/10.1186/s12888-020-02599-9
dc.identifier.urihttp://ugspace.ug.edu.gh/handle/123456789/35441
dc.language.isoenen_US
dc.publisherBMC Psychiatryen_US
dc.relation.ispartofseries275;2020
dc.subjectStreet-connected adolescentsen_US
dc.subjectSub-Saharan Africaen_US
dc.subjectSuicideen_US
dc.subjectSuicide attempten_US
dc.subjectTramadolen_US
dc.subjectAdolescentsen_US
dc.subjectAdultificationen_US
dc.subjectSelf-harmen_US
dc.subjectGhanaen_US
dc.titleAdolescent self-harm in Ghana: a qualitative interview-based study of firsthand accountsen_US
dc.typeArticleen_US

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