Alcohol and self-harm: A qualitative study

Executive Summary

This qualitative study was commissioned by Alcohol Change UK in Wales to explore how and why alcohol and self-harm are related, and how alcohol, self-harm, and related services, are experienced and understood. Eleven people who had experience with self-harm and alcohol use were recruited through mental health support organisations across England and Wales. Interviews invited participants to ‘tell their stories’ about self-harm, alcohol use, the relationship between the two practices, and their experiences with services in relation to these. 

Participants described a wide range of drinking and self-harm practices, and service experiences. Interviews highlighted the ways in which both self-harm and drinking are embedded in society and culture and do not take place separately from it. Accounts suggested that drinking and self-harm were deeply connected in multiple complex ways. 

Drinking was described as sometimes exacerbating a ‘bad headspace’ or enabling self-harm by lowering inhibitions, and sometimes as a type of self-harm in itself, or - for some - as a way of avoiding self-harm. Both alcohol use and self-harm were described by some as representing a valuable coping mechanism. Participants varied in terms of how much of a ‘problem’ either self-harm or alcohol use were at different times in their lives. 

Participants had experienced a range of services. A clear message was that current services were frequently unable to acknowledge or respond to their needs, for a number of reasons as stated in bulleted points above.

Participants highlighted the importance of communication, relationships, and accessibility, and the need for services to be able to cope with complexity and respond to need. This has implications for services relating to alcohol and self-harm, suggesting that a more flexible approach, enabling acknowledgment of the complex connections between drinking and self-harm, and the social aspects of both, is required.