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

Troya, Mlsabela; Mughal, Faraz; Dikomitis, Lisa; Chew-Graham, Carolyn A.; Corp, Nadia; Babatunde, Opeyemi O.

Authors

Mlsabela Troya

Lisa Dikomitis



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.

Journal Article Type Article
Acceptance Date Aug 16, 2019
Online Publication Date Apr 30, 2020
Publication Date 2020-05
Publicly Available Date Mar 28, 2024
Journal British Journal of General Practice
Print ISSN 0960-1643
Publisher Royal College of General Practitioners
Peer Reviewed Peer Reviewed
Volume 70
Issue 694
Pages E364-E373
DOI https://doi.org/10.3399/bjgp20X708257
Keywords GP, Management, Patients, Self-harm, review.
Publisher URL https://doi.org/10.3399/bjgp20X708257