Family responses to youth who have engaged in deliberate self-harm: A qualitative constructive grounded theory study in Sri Lanka

Like in the global context, suicide and deliberate self-harm (DSH) among youth are critical public health concerns in Sri Lanka. However, studies have mainly focused on the risk factors of suicide and deliberate self-harm with limited attention to examining the family responses to youth who have engaged in deliberate self-harm, which is vital in developing aftercare plans for prevention. This study, derived from the constructive grounded theory methodology and thematic analysis, aimed to explore how the immediate family responds to youth who engage in deliberate self-harm. A total of 40 qualitative interviews, 20 with affected youth and 20 with their family members, were analyzed. This qualitative analysis derived four themes:(1) the family’s aftercare role,(2) family accusation and reduced conversation,(3) recalling of unpleasant memories on occasions, and (4) withdrawal of family support. Findings revealed that though family plays a vital caregiver role, negative responses of the family would buffer the psychosocial well-being of the affected youth in the post-discharged period, informing us of the importance of the family’s role in helping the affected young people following deliberate self-harm. Thus, health professionals, social workers, and social service providers can contribute to minimizing the family’s negative responses through enhancing family relationships and psychoeducation.