title: Pathways to care and help-seeking experience prior to self-harm: a qualitative study in Taiwan.
abstract: BACKGROUND
  Help-seeking behavior may protect people from harming themselves. However, few studies have discussed how and why people access lay or professional help prior to self-harm.
  
  
  OBJECTIVE
  This study explored the subjective experiences of individuals with deliberate self-harm in terms of help-seeking behavior and medical care pathways.
  
  
  METHODS
  Researchers performed qualitative in-depth interviews and content analysis and used a sampling grid to recruit participants. Twenty emergency attendees between the ages of 18-55 years were interviewed on their help-seeking pathways and experiences using a standardized topic guide.
  
  
  RESULTS
  Participants identified friends, family members, healthcare personnel, and their own initiative as the primary medical care pathways. Analysis showed help-seeking experiences significantly related to the physician-patient relationship, social support, and treatment adherence. These factors were also identified as prominent themes related to medical help-seeking behavior.
  
  
  CONCLUSIONS
  Supportive attitudes and continuous care from formal and informal sources of help may facilitate help-seeking behavior, whereas negative influences from close friends or relatives may trigger a self-harm episode. Medication stockpiling and the negative aspects of close relationships should be addressed and minimized to raise the effectiveness of self-harm or suicide prevention efforts.
authors.affiliation: Department of Nursing, College of Medicine, National Taiwan University, ROC.
authors.forename: Chia-Yi
authors.initials: CY
authors.lastname: Wu
authors.forename: Rob
authors.initials: R
authors.lastname: Whitley
authors.forename: Robert
authors.initials: R
authors.lastname: Stewart
authors.forename: Shen-Ing
authors.initials: SI
authors.lastname: Liu
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D033262:Narration; D010342:Patient Acceptance of Health Care; D010817:Physician-Patient Relations; D036301:Qualitative Research; D016728:Self-Injurious Behavior / Q000517:prevention & control*; D012944:Social Support; D013624:Taiwan