Exploring general practitioners' management of self‐harm in young people: A qualitative study

Journal article

Mughal, F., Saunders, B, Lewis, Martyn, Armitage, Christopher J., Dikomitis, L., Lancaster, Gillian, Townsend, Ellen and Chew‐Graham, Carolyn A. 2024. Exploring general practitioners' management of self‐harm in young people: A qualitative study. Health Expectations. 27 (5). https://doi.org/10.1111/hex.70026
AuthorsMughal, F., Saunders, B, Lewis, Martyn, Armitage, Christopher J., Dikomitis, L., Lancaster, Gillian, Townsend, Ellen and Chew‐Graham, Carolyn A.
Abstract

Background
General practitioners (GPs) are key to the frontline assessment and treatment of young people after self-harm. Young people value GP-led self-harm care, but little is known about how GPs manage young people after self-harm.

Aim
This study aimed to understand the approaches of GPs to self-harm in young people and explore their perspectives on ways they might help young people avoid repeat self-harm.

Methods
We conducted semi-structured interviews with GPs from the National Health Service in England in 2021. GPs were recruited from four geographically spread clinical research networks and a professional special interest group. Data were analysed using reflexive thematic analysis. The study's patient and public involvement and community of practice groups supported participant recruitment and data analysis.

Results
Fifteen interviews were undertaken with a mean age of participants being 41 years and a breadth of experience in practice ranging from 1 to 22 years. Four themes were generated: GPs' understanding of self-harm; approaches to managing self-harm; impact of COVID-19 on consultations about self-harm; and ways to avoid future self-harm.

Conclusion
Negative attitudes towards self-harm within clinical settings are well documented, but GPs said they took self-harm seriously, listened to young people, sought specialist support when concerned and described appropriate ways to help young people avoid self-harm. GPs felt that relationship-based care is an important element of self-harm care but feared remote consultations for self-harm may impede on this. There is a need for brief GP-led interventions to reduce repeat self-harm in young people.

Patient and Public Contribution
A study advisory group consisting of young people aged 16–25 years with personal experience of self-harm and parents and carers of young people who have self-harmed designed the recruitment poster of this study, informed its topic guide and contributed to its findings.

KeywordsGeneral practitioner; Self-harm; Young people
Year2024
JournalHealth Expectations
Journal citation27 (5)
PublisherWiley
ISSN1369-6513
1369-7625
Digital Object Identifier (DOI)https://doi.org/10.1111/hex.70026
Official URLhttps://onlinelibrary.wiley.com/doi/10.1111/hex.70026
Publication dates
Online09 Sep 2024
Publication process dates
Accepted27 Aug 2024
Deposited19 Sep 2024
Publisher's version
License
File Access Level
Open
Output statusPublished
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Publications router: License for VOR version of this article starting on 2024-09-09: http://creativecommons.org/licenses/by/4.0/ included in notification

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Dikomitis, L. 2019. Images depicting headache pain – a tool to aid the diagnosis of cluster headache: a pilot study. Journal of Multidisciplinary Healthcare. 2019 (12), pp. 691-698. https://doi.org/10.2147/JMDH.S207128
Images depicting pain: a screening tool for cluster headache
Buture, A., Dikomitis, L., Boland, L. and Ahmed, F. 2018. Images depicting pain: a screening tool for cluster headache. Cephalalgia. 38 (Supp 1), pp. 114-115. https://doi.org/10.1177/0333102418789865
Delays in the diagnosis and misdiagnosis of cluster headache – a systematic literature review
Buture, A., Boland, J. W., Dikomitis, L. and Ahmed, F. 2018. Delays in the diagnosis and misdiagnosis of cluster headache – a systematic literature review. Cephalalgia. 38 (Supp 1), pp. MTIS2018-145.
Systematic literature review on the delays in the diagnosis and misdiagnosis of cluster headache
Buture, A., Boland, J. W., Dikomitis, L. and Ahmed, F. 2018. Systematic literature review on the delays in the diagnosis and misdiagnosis of cluster headache. Neurological Sciences. 40, pp. 25-39. https://doi.org/10.1007/s10072-018-3598-5
Visual images: an additional tool for the screening of cluster headache
Buture, A., Dikomitis, L., Boland, J. W. and Ahmed, F. 2017. Visual images: an additional tool for the screening of cluster headache. Cephalalgia. 37, p. 219.
So looking at this, you look like you've got some issues going on with your joints: Exploring case-finding in long-tern condition review consultations - the ENHANCE pilot trial
Liddle, J., Chew-Graham, C. A., Mallen, C. D., Healey, E. L., Jinks, C. and Dikomitis, L. 2017. So looking at this, you look like you've got some issues going on with your joints: Exploring case-finding in long-tern condition review consultations - the ENHANCE pilot trial. Rheumatology. 56 (IS 2). https://doi.org/10.1093/rheumatology/kex062.181
'"The man who closed the asylums": Franco Basaglia and the revolution in mental health care', by John Foot (Verso, 2015)
Dikomitis, L. 2016. '"The man who closed the asylums": Franco Basaglia and the revolution in mental health care', by John Foot (Verso, 2015). Durham University Institute for Medical Humanities.
How do clinicians think about cluster headache
Dikomitis, L., Paemeleire, K., Goadsby, P. J. and Ahmed, F. 2016. How do clinicians think about cluster headache. Cephalalgia. 36 (S 1).
Developing a diagnostic tool for the early diagnosis of cluster headache
Buture, A., Dikomitis, L. and Ahmed, F. 2016. Developing a diagnostic tool for the early diagnosis of cluster headache. Cephalalgia.
Perceptions, understandings and experiences of cluster headache patients in the north of England: a qualitative study
Dikomitis, L., Quarshie, V., Paemeleire, K., Goadsby, P. J. and Ahmed, F. 2015. Perceptions, understandings and experiences of cluster headache patients in the north of England: a qualitative study. Cephalalgia. 25 (S6).
[Review of] The Past in Pieces: Belonging in the New Cyprus, by Rebecca Bryant. Contemporary Ethnography series. Philadelphia: University of Pennsylvania Press, 2010. 224 pp.
Dikomitis, L. 2014. [Review of] The Past in Pieces: Belonging in the New Cyprus, by Rebecca Bryant. Contemporary Ethnography series. Philadelphia: University of Pennsylvania Press, 2010. 224 pp. American Anthropologist. 116 (1), pp. 194-195. https://doi.org/10.1111/aman.12085_9
Perceptions and experiences of cluster headache among patients, general practitioners and neurologists in the north of england: A qualitative study
Ahmed, F., Dikomitis, L., Zafar, H. W., Goadsby, P. and Paemeliere, P. 2014. Perceptions and experiences of cluster headache among patients, general practitioners and neurologists in the north of england: A qualitative study. Journal of Headache and Pain. 15 (S1).
Patients perceptions of the causes of migraine in Flanders (Belgium): A qualitative study
Dikomitis, L., Bonte, M., Willems, S. and Paemeleire, K. 2013. Patients perceptions of the causes of migraine in Flanders (Belgium): A qualitative study. Cephalalgia. 33 (S 8), p. 198. https://doi.org/10.1177/0333102413490487