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    Best practice when working with suicidal behaviour and self-harm in primary care: a qualitative exploration of young people’s perspectives

    Bellairs-Walsh, India and Perry, Yael and Krysinska, Karolina and Byrne, Sadhbh J. and Boland, Alexandra and Michail, Maria and Lamblin, Michelle and Gibson, Kerry L. and Lin, Ashleigh and Li, Tina Yutong and Hetrick, Sarah and Robinson, Jo (2020) Best practice when working with suicidal behaviour and self-harm in primary care: a qualitative exploration of young people’s perspectives. BMJ Open, 10 (10). e038855. ISSN 2044-6055

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    Objectives: General practitioners (GPs) have a key role in supporting young people who present with suicidal behaviour/self-harm. However, little is known about young people's opinions and experiences related to GPs' practices for such presentations, and their decisions to disclose suicidal behaviour/self-harm to GPs. Additionally, existing guidelines for the management of suicide risk and/or self-harm have not incorporated young people's perspectives. This study aimed to explore young people's views and experiences related to the identification, assessment and care of suicidal behaviour and self-harm in primary care settings with GPs. Design, setting and participants: Two qualitative focus groups were conducted in Perth, Western Australia, with 10 young people in total (Mage = 20.67 years; range: 16-24). Data were collected using a semistructured, open-ended interview schedule and analysed using thematic analysis. Results: Five major themes were identified from the focus groups. (1) Young people wanted a collaborative dialogue with GPs, which included being asked about suicidal behaviour/self-harm, informed of treatment processes and having autonomy in decision making; (2) young people were concerned with a loss of privacy when disclosing suicidal behaviour/self-harm; (3) young people viewed labels and assessments as problematic and reductionist-disliking the terms 'risk' and 'risk assessment', and assessment approaches that are binary and non-holistic; (4) young people highlighted the importance of GPs' attitudes, with a genuine connection, attentiveness and a non-judgemental demeanour seen as paramount; and (5) young people wanted to be provided with practical support and resources, followed-up, and for GPs to be competent when working with suicidal behaviour/self-harm presentations. Conclusions: Our study identified several concerns and recommendations young people have regarding the identification, assessment and care of suicidal behaviour/self-harm in primary care settings. Taken together, these findings may inform the development of resources for GPs, and support progress in youth-oriented best practice.

    Item Type: Article
    Keywords: child & adolescent psychiatry; mental health; primary care; qualitative research; quality in health care; suicide; self-harm;
    Academic Unit: Faculty of Science and Engineering > Psychology
    Item ID: 16682
    Identification Number:
    Depositing User: Sadhbh Byrne
    Date Deposited: 08 Nov 2022 16:55
    Journal or Publication Title: BMJ Open
    Publisher: BMJ Publishing Group
    Refereed: Yes
    Use Licence: This item is available under a Creative Commons Attribution Non Commercial Share Alike Licence (CC BY-NC-SA). Details of this licence are available here

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