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01-12-2020 | Suicide | Research article

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

Authors: Emmanuel N-B Quarshie, Mitch G. Waterman, Allan O. House

Published in: BMC Psychiatry | Issue 1/2020

Abstract

Background

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 street-connected 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.

In Ghana, trotros are privately owned minibuses that travel fixed routes departing to their destinations when filled, and they can be boarded anywhere along the route. A trotro is typically operated by two people: a driver and a conductor (also called ‘trotro mate’ or ‘mate’). Usually, the driver employs the mate (who is typically a school drop-out, an unemployed youth, or a street-connected young person) and pays him after the day’s work.

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Name of slum anonymised for ethical reasons

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Title: Adolescent self-harm in Ghana: a qualitative interview-based study of first-hand accounts
Authors: Emmanuel N-B Quarshie
Mitch G. Waterman
Allan O. House
Publication date: 01-12-2020
Publisher: BioMed Central
Keywords: Suicide
Suicide
Tramadol
Published in: BMC Psychiatry / Issue 1/2020
Electronic ISSN: 1471-244X
DOI: https://doi.org/10.1186/s12888-020-02599-9

2024 ASCO Annual Meeting

Springer Medicine

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

Abstract

Background

Methods

Results

Conclusions

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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