Pre-Registration Mental Health Nursing Students Who Witness Self-Harm Amongst Service Users During Placement: A Cross-Sectional Study.

Mental health nursing (MHN) students may witness self-harm on placements; however, little is known regarding the experience of MHN students who do witness this. This study aimed to understand the personal impact of witnessing self-harm events upon MHN students who are on placement, with three objectives: (1) To identify the types of self-harm witnessed by MHN students; (2) To evaluate MHN students' perceived self-competence in working with service users who have self-harmed; and (3) To assess the potential psychological trauma upon MHN students after witnessing self-harm. A cross-sectional questionnaire comprising researcher-generated Likert-style items and open-ended response questions was utilised. Descriptive analysis was completed of 84 responses from MHN students. The types of self-harm witnessed included cutting (65 participants; 77.4%); head-banging/punching (62 participants; 73.8%); and ligation (36 participants; 42.9%). Additionally, we identified factors that either hindered or aided the MHN students in developing resilience post witnessing self-harm. These findings are presented as three qualitative themes, and are: resilience; sources of stress and sources of support. Key findings were: (i) current MHN students can experience a range of negative outcomes after witnessing a self-harm incident which can include wanting to withdraw from studies; (ii) student experience of witnessing self-harm needs to be better understood and responded to; and finally, (iii) universities and placement providers should deliver relevant training, with trauma informed care (TIC) pedagogy potentially being an effective intervention. Ultimately, we recommend a joined-up approach from universities and practice partners to address these issues.