Abstract
Self-harming inpatients are reported to be extremely challenging to deal with on psychiatric units, and the necessity to strengthen staff capacity towards these patients are emphasized in the literature. This article is based on a study which explored what challenges staff face when working with self-harming inpatients. The study was based on triangulation of data, methods and analysis. Challenges were found within the domains of understanding the patient, dealing with the patient on the unit, intervening during the process of self-harming and staff's own role-function (1). The challenges were interpreted within a theoretical framework which conceptualized self-harming as a four-dimensional phenomenon. In order to find how these dimensions of self-harming were involved in the challenges, the analysis was performed and validated through three steps in the analysing process; identification, correspondence and coherence. The relational dimension of self-harming was the most widespread in the challenges, followed by the functional dimension. The analysis confirms the complexity of self-harming and highlights the need to strengthen staff's relational capacity towards self-harming inpatients. The most complex challenge to deal with was the unpredictability of self-harming, followed by challenges relating to the contagion effect, the assessment of self-harming and focus in the relationship with the self-harming inpatient.