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

India Bellairs-Walsh, Yael Perry, Karolina Krysinska, Sadhbh J. Byrne, Alexandra Boland, Maria Michail, Michelle Lamblin, Kerry L. Gibson, Ashleigh Lin, Tina Yutong Li, Sarah Hetrick, Jo Robinson

Research output: Contribution to journalArticleResearchpeer-review

2 Citations (Scopus)

Abstract

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 (M age = 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.

Original languageEnglish
Article numbere038855
Number of pages12
JournalBMJ Open
Volume10
Issue number10
DOIs
Publication statusPublished - 28 Oct 2020
Externally publishedYes

Keywords

  • child & adolescent psychiatry
  • mental health
  • primary care
  • qualitative research
  • quality in health care
  • suicide & self-harm

Cite this