Lack of self-harm services and limited consultation time preventing provision of good care

Lack of self-harm services and limited consultation time preventing provision of good care

GPs recognise that self-harm is a serious risk factor for suicide but many feel ill-equipped to help patients manage their behaviour, it has emerged.

Limited consultation time with people who self-harm and a lack of self-harm services in primary care are preventing the provision of good care.

The findings are from a study conducted jointly by University College Cork and Keel University in Britain and published in the British Journal of General Practice.

It is the first review of primary care literature on GPs and self-harm and has significant implications for the training of GPs here.

Self-harm is a serious risk factor for suicide, and more than half of young people who die by suicide have a history of self-harm. There are increasing self-harm rates reported among middle-aged man and people aged over 65 years.

The research is based on a review and analysis of 12 studies published between 1997 and 2016 involving almost 800 GPs and family medicine physicians from Europe, America and Australia.

It suggests that the development of self-harm clinical guidelines with people who self-harm and GPs would make it easier to provide effective care.

“Evidence indicates that most self-harm presentations will occur in community settings,” said Dr Isabela Troya from UCC and the National Suicide Research Foundation (NSRF).

“We know that in Ireland there are over 2,500 GPs who are at the frontline dealing with people's physical and mental health conditions.

“Our review shows that GPs recognise self-harm as a serious risk factor for suicide, but many report feeling unprepared to manage self-harm.”

Previous research conducted by NSRF with 469 GPs found that they had limited suicide prevention training.

Dr Troya, who was the second research paper study author, said GPs and primary care were ideally positioned to address mental health issues.

“The role of the GP is multidimensional and includes assessment, treatment and referral to specialist care when necessary.

Primary care is well placed to promote mental health, and identify people at risk of self-harm and suicide at an early stage.

Dr Troya said it also emerged that parents and carers of young people want to have a role in the management of their self-harm behaviour.

However, the involvement of parents and carers in GP consultations with young people would have to be agreed first.

*Samaritans, 116 123 and Childline, 1800 66 66 66. www.aware.ie; www.yourmentalhealth.ie and spunout.ie.

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