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The purpose of this paper is to present some results of a qualitative study exploring people's memories of the pathways to the first episode of self-wounding. Specifically it will focus on the issue of “suicidality”.

In total, 11 participants, aged between 19 and 50, were described. They were asked to describe their first episode of self-wounding. The interviews were conducted using a semi-structured topic guide. An initial thematic and a subsequent narrative analysis were used to explore the participants’ stories.

The narratives of self-wounding show that the first episode occurs in a complex landscape of interactions between events and emotions. Even when participants were aware of suicidal feelings before self-wounding, the suicidal intention was abandoned as the self-wounding was shown to be an effective method for dealing with distress. For most of the participants the self-wounding was not associated with suicidality but with a strong need to gain or regain control of an emotionally charged and chaotic environment.

Focusing on the first episode of self-harm holds the key to a better appreciation of the underlying meanings of self-wounding as a complex and dynamic experience. It can provide health care practitioners with a new direction to understanding people's individual motivations rather than focusing relying on behaviour generalised assumptions.

This study provides a rare insight into the first episode of self-harm as a unique event. It is also a rare example of publicly funded service-user research with a focus on issues which are meaningful to them.

This special section of Studies in Symbolic Interaction offers papers originally presented at the Second Anselm Strauss Colloquium, “Forty Years of Grounded Theory,” held at UC San Francisco on October 5, 2007.¹ The colloquium celebrated several events: the 40th anniversary of The Discovery of Grounded Theory (Glaser & Strauss, 1967), the 40th anniversary of the establishment of the Doctoral Program in Sociology at UCSF (1968), the centennial of the UCSF School of Nursing (2007), and the life and work of Anselm Strauss.²

The three aims of the study reported were to investigate the functions of self‐harm in a population of patients detained in the Peaks Unit at Rampton hospital, to investigate the context and nature of this behaviour and to examine how staff respond to incidents of self‐harm. The findings indicate that there may be some functions of self‐harm specific to this population in addition to those found in other settings, namely expression of aggression and revenge. The context and nature of incidents were similar to those found in other secure settings. A range of staff responses were observed, and indicated high demand on staff time and resources. Limitations of the methods are discussed, with proposals for future research.

Deciding the best course of treatment for a drug or alcohol user can be a complex one. Continuing our look at harm reduction and abstinence, we ask what the best plans are for Nigella, a young woman with mental health problems who uses heroin to prevent recurring self‐harm. In a refreshing and challenging critique Lesley Don explores the decision‐making process towards that treatment. Should Nigella stop her heroin use? If she does, will she self‐harm? Which harm is more desirable? And why, as professionals, do we seek one solution over another?

There is a dearth of research exploring pathways to episodes of deliberate self‐harm (DSH) within mentally ill men in high‐secure hospitals. This study aims to explore pathway(s) to episodes of self‐harm experienced by this group over the course of their life.

A total of seven men with a history of repetitive DSH participated in audio‐taped semi‐structured interviews. Transcribed interviews were analysed using grounded theory methods.

Two pathways to episodes of DSH emerged and were termed: the relief, and the response to mental health problems pathways. Participation within a dyadic suicide pact emerged as an unexpected theme.

There were a number of limitations within this study. Participants did not describe DSH episodes, which occurred within the high‐secure hospital and it was unclear as to the stage of their illness or whether co‐morbid difficulties were present during the episodes of DSH. Further research is required to substantiate the two pathways to episodes of DSH found within this study.

The present study offers a theoretical framework for clinicians working with mentally ill men within high‐secure hospitals, who have a history of DSH and identifies the need to carefully assess each individual episode of DSH.

This study is the first to explore pathways to episodes of self‐harm as experienced by mentally ill men within a high‐secure hospital by interviewing patients directly.

The purpose of this paper is to analyse the role of non‐violent protest (satyagraha) in a multinational automobile plant in India that has suffered from considerable employee relations problems.

The paper employs a case study of a Japanese‐owned company using data obtained from 30 personal interviews and from internet media sources.

It is found that workers initially pursued their protests through satyagraha‐style methods before taking on a more violent posture when company management refused to accept any notion of jointly seeking a new harmony. The reasons for these developments are explored.

The paper has implications for the manner in which scholars and practitioners view the respective roles, significance, and management of satyagraha and non‐satyagraha protest in Indian companies.

The importance of satyagraha in Indian employee relations is under‐researched in comparison with other factors, and is especially significant for culturally‐unaware multinational companies in successfully understanding and managing protest in the workplace context.

Suicide is the main cause of death among prison inmates, comprising almost half of all deaths in penal institutions in the Netherlands. Suicides in prisons have major consequences. They are a cause of distress to prison staff, other inmates, relatives and partners. They may cause unrest among other inmates.Detecting suicide is difficult and requires the collection of information that may not be generally available on the ‘normal’ prison inmate.This paper describes research undertaken to identify factors that might indicate high suicide risk in a prison inmate. These factors were then weighted to provide a suicide screening tool that was able to identify 95% of inmates at risk of suicide.However identification of risk is only the first step; steps must be taken thereafter to ensure suicide does not occur. The effectiveness of preventive measures is an important area for future research.

This paper seeks to highlight the findings from a research project on improving treatment engagement for clients with personality difficulties.

The authors provide an overview of the studies conducted to date. These are a systematic review of the literature examining non‐completion of psychosocial treatment by people with personality disorder, a systematic review of assessments to measure treatment engagement, and a Delphi survey of both staff and patients' views on factors that impact on engagement in psychosocial treatment for this client group.

Poor engagement with psychosocial treatment is an issue for clients with personality disorder and rates of non‐completion are high. Discontinuation of treatment is associated with adverse clinical outcomes. Although a number of assessments exist for measuring engagement, none can be described as comprehensive and few are adequately validated. Engagement factors identified from the survey were broadly in keeping with previous work, but additional factors specific to this client group were identified. A treatment readiness model for people with personality difficulties is described.

Research outputs from the project are a set of specifications for good practice in facilitating engagement, and a web‐based training package aimed at helping staff improve their understanding of their clients' engagement issues.

The findings will be useful to service managers as well as clinicians working directly with people with personality difficulties. Improving client engagement will improve clinical outcomes and service cost‐efficiency.

This study seeks to explore the content analysis of two qualitative studies looking at experiences of staff working with clients who self‐harm. One of the groups work with women clients, and the other works with men. Both groups of staff in this study work with people with mild learning disabilities who self‐harm. The sample is taken from nurses working in both medium security and low security in the UK.

The staff were interviewed using semi‐structured interviews and had considerable control over the direction of the interview.

Although some allowances should be made because the two groups worked in different services, there were some interesting variations in the themes of the results. The two groups of staff based their discussions on five central themes: types of self‐harm, perceived reasons for self‐harm, staff personal responses, client treatment options, and staff support.

Staff reported experiencing strong emotional responses to incidents of self‐harm. Types of behaviour tended to vary between men and women. Staff asked for more training and time for support groups to meet. Some staff (particularly those working with women) think that self‐harm should be allowed within reason.

This research will be valuable to many types of residential service where clients may use self‐harm as a coping strategy. The authors recommend services adopting a harm minimisation approach to self‐harm.