More ‘masculine’ styles of self-harm such as causing fights or tying ligatures were described, as well as other less severe behaviours such as picking and scratching. Swallowing items, a behaviour traditionally associated with women on the unit, was also described by one interviewee.
Some of the perceived functions were relational, a response to bullying or powerlessness. A common thought was that men were using self-harm as a means of communication, or because of difficulties in getting people to understand their distress. Another popular perception was that men self-harmed as a way to bring on or stop ward moves.
Many of the strategies used by staff rested on the maintenance of strong therapeutic relationships, as well as supporting peer and family relationships. Maintaining self-esteem and focussing on men’s strengths was another common strategy as described by staff. Art and psychological therapy were seen as extremely successful.