How do general practitioners conceptualise self-harm in their older patients? A qualitative study

Little is known about how general practitioners (GPs) conceptualise self-harm in older people. The aim of this study was to explore GPs' understanding of the reasons for recent self-harm in an older patient.

Short questionnaires were sent to the GPs of patients aged 80 years or older who had recently self-harmed and were participants in a qualitative study about self-harm. Questions evaluated GPs’ understanding of the self-harm. Thematic analysis was used to identify and analyse themes.

Thirteen GP responses were analysed. GPs could identify multiple factors contributing to self-harm in their patients but did not see a role for themselves in addressing these issues. They feared repetition of self-harm if these underlying contributory factors, including depression, did not change.

Targeted education and practical options for GPs regarding management of the issues underlying self-harm in older people are needed. Families and carers may be underused allies in management. These strategies may serve to counter therapeutic nihilism and clinician isolation.