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Deliberate self-harm cases: a primary care perspective.

Anne Poustie1, Ron G Neville

  • 1Threshold Day Services, Dundee. anne.poustie@tpct.scot.nhs.uk

Nursing Standard (Royal College of Nursing (Great Britain) : 1987)
|September 16, 2004
PubMed
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Deliberate self-harm (DSH) is a chronic health condition requiring integrated primary and secondary care support. General practice should lead interventions and improve liaison with secondary care for better patient outcomes.

Area of Science:

  • Public Health
  • Psychiatry
  • General Practice

Background:

  • Deliberate self-harm (DSH) presents a significant challenge in urban primary care settings.
  • Understanding patient pathways and outcomes is crucial for effective intervention.

Purpose of the Study:

  • To ascertain cases of DSH presenting to an urban general practice.
  • To evaluate the one-year outcomes for these patients.
  • To explore patterns of care and service utilization.

Main Methods:

  • An exploratory study involving primary care team members recording DSH episodes over six months.
  • Tracking patient care over 12 months using IT systems, records, and staff discussions.
  • Interviews with primary care, secondary care, and voluntary sector staff, plus patient interviews with community psychiatric nurses.

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Main Results:

  • Twenty-five patients (15-44 years, 19 female) presented with DSH.
  • Most patients had a history of DSH and near-universal substance misuse.
  • All patients survived 12 months; only one of 13 initially in secondary care maintained ongoing contact, with others showing high, chaotic GP service use.

Conclusions:

  • DSH should be viewed as a long-term health condition.
  • Support and interventions should be integrated within general practice.
  • Enhanced liaison between primary and secondary care and increased primary care team support are necessary.