Aishah Madinah Haris
Harm minimisation for self-harm: a cross-sectional survey of British clinicians’ perspectives and practises
Haris, Aishah Madinah; Pitman, Alexandra; Morant, Nicola; Rowe, Sarah L.; Mughal, Faraz; Bakanaite, Evelina
Authors
Abstract
Objective Harm minimisation for self-harm is an alternative to preventive strategies and focuses on maximising safety when self-harming. We explored the views of clinicians on harm minimisation for self-harm to describe reported use and acceptability in clinical practice. Design A cross-sectional study using an online survey consisting of fixed-choice and open-ended questions. Setting Primary and secondary care practices in England, Scotland and Wales. Participants Snowball sampling of UK-based clinicians (n=90; 67% female) working with people who self-harm and who have or have not previously recommended harm minimisation methods to patients. Results Of the 90 clinicians sampled, 76 (84%) reported having recommended harm minimisation techniques to people in their care who self-harm. Commonly recommended techniques were snapping rubber bands on one's wrist and squeezing ice. Other techniques, such as teaching use of clean instruments when self-harming, were less likely to be recommended. Perceived client benefits included harm reduction and promotion of the therapeutic relationship. Perceived potential limitations of a harm minimisation approach for self-harm were (a) potential worsening of self-harm outcomes; (b) ethical reservations; (c) doubts about its effectiveness and appropriateness; and (d) lack of training and clear policies within the workplace. Conclusions In our sample of UK-based clinicians in various settings, harm minimisation for self-harm was broadly recommended for clients who self-harm due to perceived client benefits. However, future policies on harm minimisation must address clinicians' perceived needs for training, well-defined guidelines, and clear evidence of effectiveness and safety to mitigate some clinician concerns about the potential for further harm.
Journal Article Type | Article |
---|---|
Acceptance Date | Apr 29, 2022 |
Online Publication Date | Jun 3, 2022 |
Publication Date | Jun 3, 2022 |
Journal | BMJ Open |
Publisher | BMJ Publishing Group |
Peer Reviewed | Peer Reviewed |
Volume | 12 |
Issue | 6 |
Article Number | ARTN e056199 |
DOI | https://doi.org/10.1136/bmjopen-2021-056199 |
Keywords | qualitative research; mental health; suicide & self-harm |
Publisher URL | https://bmjopen.bmj.com/content/12/6/e056199 |
Files
e056199.full.pdf
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Publisher Licence URL
https://creativecommons.org/licenses/by-nc/4.0/
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