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British Journal of General Practice
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Research Article

Management of deliberate self harm in general practice: a qualitative study.

L R Prasad, M M Gantley and M R Underwood
British Journal of General Practice 1999; 49 (446): 721-724.
L R Prasad
Department of General Practice and Primary Care, St Bartholomew's and the Royal London School of Medicine and Dentistry, Queen Mary and Westfield College, Medical Sciences, London.
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M M Gantley
Department of General Practice and Primary Care, St Bartholomew's and the Royal London School of Medicine and Dentistry, Queen Mary and Westfield College, Medical Sciences, London.
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M R Underwood
Department of General Practice and Primary Care, St Bartholomew's and the Royal London School of Medicine and Dentistry, Queen Mary and Westfield College, Medical Sciences, London.
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Abstract

BACKGROUND: It has been estimated that the incidence of deliberate self harm (DSH) is at least 10 times that of suicide. Accident and emergency discharge figures also point to an almost doubling of reported cases of DSH in the early 1990s. AIM: To assess general practitioners' (GPs') views on, and educational requirements for, managing patients following an episode of DSH. METHOD: A qualitative study with 14 GPs (seven male and seven female) from two outer-London boroughs, selected in order to provide a maximum variety sample. Interviews took place between February and April 1997, and data were analyzed using the principles of grounded theory. RESULTS: Most GPs felt that all patients presenting with DSH should be assessed by a psychiatrist. They expressed a preference for working with a community psychiatric nurse rather than a counsellor. Suggestions to improve their working relationship with community mental health teams included provision of one centralized point of referral and ease of access to the service in times of crisis. GPs were sceptical of guidelines, emphasizing that they needed joint ownership in writing them, but most importantly that they needed adequate resources to implement them. Specific changes to postgraduate education were suggested, such as individual educational portfolios. CONCLUSION: Improved working relationships between GPs and community mental health teams are needed in order to provide a more efficient and effective service for patients. Lifelong learning needs to be adapted in a style and approach to suit GPs' individual requirements.

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British Journal of General Practice: 49 (446)
British Journal of General Practice
Vol. 49, Issue 446
September 1999
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Management of deliberate self harm in general practice: a qualitative study.
L R Prasad, M M Gantley, M R Underwood
British Journal of General Practice 1999; 49 (446): 721-724.

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Management of deliberate self harm in general practice: a qualitative study.
L R Prasad, M M Gantley, M R Underwood
British Journal of General Practice 1999; 49 (446): 721-724.
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More in this TOC Section

  • A primary care intervention programme for obesity and coronary heart disease risk factor reduction.
  • Access to health care prior to suicide: findings from a psychological autopsy study.
  • Suicide and attempted suicide in France: results of a general practice sentinel network, 1999-2001.
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Print ISSN: 0960-1643
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