Role of the GP in the management of patients with self-harm behaviour: A systematic review

Journal article


Dikomitis, L., Faraz Mughal, M. Isabela Troya, Lisa Dikomitis, Carolyn A. Chew-Graham, Nadia Corp and Opeyemi O Babatunde 2020. Role of the GP in the management of patients with self-harm behaviour: A systematic review. British Journal of General Practice (BJGP). 70 (694), pp. e364-e373. https://doi.org/10.3399/bjgp20X708257
AuthorsDikomitis, L., Faraz Mughal, M. Isabela Troya, Lisa Dikomitis, Carolyn A. Chew-Graham, Nadia Corp and Opeyemi O Babatunde
Abstract

Background
Self-harm is a serious risk factor for suicide, a major public health concern, and a significant burden on the NHS. Rates of self-harm presentation in primary care are rising and GPs interact with patients both before and after they have self-harmed. There is significant public and political interest in reducing rates of self-harm, but there has been no robust synthesis of the existing literature on the role of GPs in the management of patients who self-harm.

Aim
This study aimed to explore the role of the GP in the management of patients with self-harm behaviour.

Design and setting
A systematic review and narrative synthesis of primary care literature.

Method
This systematic review was conducted and is reported in line with PRISMA guidance. Electronic databases systematically searched were MEDLINE, PsycINFO, EMBASE, CINAHL, Web of Science, and AMED. Two independent reviewers conducted study screening and selection, data extraction, and quality appraisal of all included studies. Thematic analysis was conducted.

Results
From 6976 unique citations, 12 studies met eligibility criteria and were included. These 12 studies, published from 1997–2016, of 789 GPs/family medicine physicians from Europe, the US, and Australia were of good methodological quality. Five themes were identified for facilitating GP management of self-harm: GP training, improved communication, service provision, clinical guidelines, and young people. Four barriers for GP management of self-harm were identified: assessment, service provision, local, and systemic factors.

Conclusion
GPs recognise self-harm as a serious risk factor for suicide, but some feel unprepared for managing self-harm. The role of the GP is multidimensional and includes frontline assessment and treatment, referral to specialist care, and the provision of ongoing support.

KeywordsGeneral practice; Primary health care; Self-harm; Suicide; Systematic review
Year2020
JournalBritish Journal of General Practice (BJGP)
Journal citation70 (694), pp. e364-e373
PublisherRoyal College of General Practitioners
ISSN0960-1643
1478-5242
Digital Object Identifier (DOI)https://doi.org/10.3399/bjgp20X708257
Official URLhttps://bjgp.org/content/70/694/e364
Publication dates
Online30 Apr 2020
Publication process dates
Accepted16 Apr 2019
Deposited19 Jun 2023
Output statusPublished
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