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Speaker: Dr. Clara Bergen
The Centre for Mental Health Research at the School of Health Science, City, University of London welcomes Dr. Clara Bergen to discuss their findings on gatekeeping access to mental health services after self-harm as part of the research seminar series.
Content warning: Detailed descriptions of self-harming thoughts and behaviors such as suicide, self-inflicted injuries and disordered eating. Discussions of sexual, physical and psychological abuse. Depictions of discriminatory attitudes and actions.
When a person is seen in a UK Emergency Department for self-harm or suicidal ideation, they can be referred to mental health services.
This study explored decisions not to refer to community mental health services despite a request for support, resulting in continued mental health difficulties or self-harm.
We take a novel methodological approach by analysing and triangulating evidence from 46 video-recorded psychosocial assessments, one-week and three-month follow-up interviews with participating patients and carers, participants’ medical files, and documentation of the referral process in medical records and discharge letters.
We reveal four interrelated factors that regularly contribute to decisions not to provide further care and show that people in crisis are pressured to align with these as reasonable.
About the speaker
Clara Bergen is a research fellow at City University of London School of Health Sciences, Division of Health Services Research and Management. She is trained in medical sociology and study health care disparities, health behaviors, mental health care, and clinical communication using mixed methods.
Her work speaks to a broader theoretical and social agenda by exposing the micro-level processes that underlie macro-level disparities in patients’ experiences of stratified healthcare systems.