• Rachel Parker.
• DECIPHer, School of Social Sciences, Cardiff University, 1-3 Museum Place, Cardiff, CF10 3BD, UK. Electronic address: parkerr9@cardiff.ac.uk.
• Public Health. 2018 Jun 1; 159: 8-13.

ObjectivesGrounded theory analysis of secondary school staff and pupil perceptions about the barriers to preventative work for adolescent self-harm within the secondary school setting in Wales.Study DesignQualitative and grounded theory.MethodsTwo secondary schools in Wales were purposefully sampled for variation. Four group interviews took place using qualitative research methods (Participatory Rapid Appraisal) with six school-based professionals and six students aged more than 16 years. Three pupil participants had long-term experience themselves of self-harming behaviours; all the remaining participants had encountered pupils who self-harmed. The research interviews were transcribed verbatim, generating school context-dependent information. This was analysed through the logic of abduction using the constant comparative grounded theory method because of its ability to focus on axial coding for context. The ontology that shaped this work was critical realism within a public health paradigm.ResultsA theoretical model of stigma resulted from the grounded theory analytical process, specifically in relation to staff and student perceptions about adolescent self-harm within the institutional context. This meant that social-based behaviours in the secondary school setting centred on the topic and behaviour of adolescent self-harm were structured by stigma.ConclusionsThe findings of this study offer an explanation on the exclusion of adolescent self-harm from preventative work in secondary schools. The stigma model demonstrates that adolescent self-harm is excluded from the socio-cultural norms of the institutional setting. Applying the UK Equality Act (2010), this is discrimination. Further research on the institutional-level factors impacting adolescent self-harm in the secondary school context in England and Wales is now urgently needed.Copyright © 2018 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

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