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

Faraz Mughal · Maria Isabela Troya · Lisa Dikomitis · Carolyn Anne Chew-Graham · Opeyemi O. Babatunde

55 citations0/0 files storedBritish Journal of General Practice

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Suicide and Self-Harm Studies Primary Care and Health Outcomes Homicide, Infanticide, and Child Abuse

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.

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2009Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement 2009Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement 2009Preferred reporting items for systematic reviews and meta-analyses: the PRISMA Statement.2012Self-harm and suicide in adolescents 2006Guidance on the conduct of narrative synthesis in systematic reviews: A product from the ESRC Methods Programme 2013Non-suicidal self-injury v. attempted suicide: new diagnosis or false dichotomy?2007Self-harm in England: a tale of three cities 2012Assessment of publication bias, selection bias, and unavailable data in meta-analyses using individual participant data: a database survey

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