Self-harm in South Asian women: a literature review informed approach to assessment and formulation

The rates of self--harm among South Asian women in the United Kingdom are much higher than among their White counterparts. However, the explanation for this is far from clear, and there is a need for more culturally informed assessments for this group. Using literature review we identified cultural factors associated with self--harm in South Asian women. These findings were used to guide the clinical assessment of an Asian woman who had self--harmed using a personal narrative approach. Three independent clinicians analysed the narrative and identified important themes that gave an insight into the problems associated with the incident, arriving at a cultural formulation. Our interview showed that specific cultural factors, such as level of acculturation, cultural conflicts, stigma and interpersonal relationships, were important factors associated with distress and resilience. Literature reviews can help in conducting culturally competent assessments and enable better interventions for this group of patients. The key cultural areas identified are discussed in detail.