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Management of deliberate self harm in general practice: a qualitative study
L R Prasad1, M M Gantley, M R Underwood
1Department of General Practice and Primary Care, St Bartholomew's and the Royal London School of Medicine and Dentistry, Queen Mary and Westfield College, Medical Sciences, London.
Summary
General practitioners (GPs) need better support and education for managing deliberate self harm (DSH) patients. Improved collaboration with community mental health teams is crucial for effective patient care.
Area of Science:
- Primary Care Medicine
- Psychiatry
- Mental Health Services Research
Background:
- Deliberate self harm (DSH) is significantly more common than suicide.
- Reported cases of DSH nearly doubled in the early 1990s.
Purpose of the Study:
- To evaluate general practitioners' (GPs') perspectives on managing patients post-DSH.
- To identify GPs' educational needs in handling DSH cases.
Main Methods:
- Qualitative study involving 14 GPs from diverse backgrounds in outer London.
- Interviews conducted between February and April 1997, analyzed using grounded theory.
Main Results:
- GPs advocate for psychiatric assessment for all DSH patients.
- Preference for collaboration with community psychiatric nurses over counselors.
- GPs desire centralized referrals, crisis access, and resource allocation for DSH management.
- Skepticism towards guidelines without GP input and resources; suggestions for postgraduate education include individual portfolios.
Conclusions:
- Enhanced collaboration between GPs and community mental health teams is essential for efficient and effective patient services.
- Lifelong learning for GPs must be tailored to individual needs and learning styles.