Abstract
Self-harm and aggression are common behaviours exhibited in inpatient wards. Staff attitudes and perceptions influence their interactions with Service users (SUs) who exhibit these behaviours. This study employed Interpretative Phenomenological Analysis (IPA) to guide the analysis of semi-structured interviews with eight clinical staff members currently working in mental health inpatient wards and who had experience caring for SUs who engage in self-harm and aggression. Three superordinate themes emerged from the data analysis. These included: The importance of ‘Understanding why’ service users self-harmed or were aggressive and how talking about this was a key intervention; aggression and self-harm were understood differently by some. ‘Pressures from different directions’ describe the intense pressure that participants experienced when working on the ward, balancing demands from management and supporting SUs the impact that this had on their own mental health was discussed. ‘The restrictive environment’ was discussed in relation to self-harm and aggression. The ward environment was seen as contributing to self-harm and aggression but was also utilised as an intervention to manage these behaviours. The findings are considered in relation to trauma-informed environment theory, the cognitive-emotional model of ‘dual harm’ and existing research. Implications for clinical practice and future research are discussed.