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

Area of Science:

• Psychiatry
• Adolescent Health
• Cultural Psychology

Background:

• Adolescent self-harm is prevalent in sub-Saharan Africa, comparable to high-income countries.
• Qualitative studies on adolescent self-harm experiences in sub-Saharan Africa are scarce.
• This study explores Ghanaian adolescents' first-person accounts of self-harm to understand cultural interpretations.

Purpose of the Study:

• To explore the lived experiences of Ghanaian adolescents who self-harm.
• To understand the cultural context and interpretive repertoires surrounding adolescent self-harm in Ghana.
• To identify factors contributing to self-harm among in-school and street-connected adolescents.

Main Methods:

• Semi-structured interviews were conducted with 36 adolescents (24 in-school, 12 street-connected).
• Experiential thematic analysis was applied to the qualitative data.
• Focus on first-person accounts and cultural interpretations of self-harm.

Main Results:

• Powerlessness within the family and unwanted adultification were key precursors to self-harm.
• Adultification played a contradictory role, sometimes acting as a protective factor for street-connected adolescents.
• In-school adolescents described self-harm as enacting taboo emotions, a social injury, or religious transgression, and sometimes as improving social relations.

Conclusions:

• Familial relational problems and interpersonal difficulties are proximal causes of adolescent self-harm.
• Self-harm is an understandable communicative signal in response to powerlessness and family difficulties.
• Findings have implications for service planning in Ghana and may be generalizable to other sub-Saharan African countries.