Table 3

Themes and subthemes from caregivers’ interviews

I. Contextual factors related to self-harm.
  1. Interpersonal conflict with family member, acquaintance, workmate, friend.

  2. Exposure to recent self-harm by someone known.

  3. Due to a religious vow.

  4. Overwhelming physical pain.

II. Formulation and current feelings about the attempt.
Formulation
  1. Self-harm as an act to get attention.

  2. Sense of physical problem being extreme and circumstances exceptional.

  3. Self-harm as an option to deal with stressors as learnt from others who have acted similarly.

  4. Shameful act causing embarrassment to the family.

Current feelings
  1. Feelings of helplessness and guilt.

  2. Feelings of anger.

  3. Fear of repetition.

III. Treatment related experiences around a self-harm attempt, help-seeking and barriers to help-seeking.
  1. Treatment experiences prior to attempt unhelpful.

  2. Counselling to help them make better choices.

  3. Counselling may not be effective due to the reasons for self-harm interfering with the benefits.

IV. Strategies to help them in future.
  1. By monitoring their company closely.

  2. By letting them know how much their act has affected the family.

  3. By getting professional help such as counselling.

  4. By following the doctor’s recommendations.