scholarly journals General Practitioners’ Accounts of Patients Who Have Self-Harmed

Crisis ◽  
2016 ◽  
Vol 37 (1) ◽  
pp. 42-50 ◽  
Author(s):  
Amy Chandler ◽  
Caroline King ◽  
Christopher Burton ◽  
Stephen Platt
Keyword(s):  
Risk Assessment ◽  
General Practitioners ◽  
Suicide Risk ◽  
Assessment Method ◽  
Service Development ◽  
Structured Interviews ◽  
Increase Risk ◽  
Self Harm ◽  
The Right ◽  
The Relationship

Abstract. Background: The relationship between self-harm and suicide is contested. Self-harm is simultaneously understood to be largely nonsuicidal but to increase risk of future suicide. Little is known about how self-harm is conceptualized by general practitioners (GPs) and particularly how they assess the suicide risk of patients who have self-harmed. Aims: The study aimed to explore how GPs respond to patients who had self-harmed. In this paper we analyze GPs’ accounts of the relationship between self-harm, suicide, and suicide risk assessment. Method: Thirty semi-structured interviews were held with GPs working in different areas of Scotland. Verbatim transcripts were analyzed thematically. Results: GPs provided diverse accounts of the relationship between self-harm and suicide. Some maintained that self-harm and suicide were distinct and that risk assessment was a matter of asking the right questions. Others suggested a complex inter-relationship between self-harm and suicide; for these GPs, assessment was seen as more subjective. In part, these differences appeared to reflect the socioeconomic contexts in which the GPs worked. Conclusion: There are different conceptualizations of the relationship between self-harm, suicide, and the assessment of suicide risk among GPs. These need to be taken into account when planning training and service development.

Queer citizens and the perils of the neoliberal city: Racialized narratives of homophobic hate crime in Oslo, Norway

Sexualities ◽  
2021 ◽  
pp. 136346072110193
Author(s):  
Henning Kaiser Klatran
Keyword(s):  
Risk Assessment ◽  
Hate Crime ◽  
State Violence ◽  
Structured Interviews ◽  
Mainstream Media ◽  
Lgbt Community ◽  
Lgbt People ◽  
Queer Citizenship ◽  
The Relationship

This article examines the relationship between queer citizenship, state violence and the exclusion of racialized, homophobic ‘others’. Drawing on semi-structured interviews with LGBT people in Oslo, Norway, I investigate the presence of racialization in narratives of homophobic hate crime. The findings suggest that racialization structures narratives of risk assessment among several of the participants. However, in these narratives, racialization often operates through place-specific references, rather than racial and ethnic markers of identity. The narrative work thus displays ambivalence and a disassociation from racism. I argue that these narratives feed on an already established conflation of space, ethnicity, religion and homophobia, to which both mainstream media and part of the LGBT community contribute.

scholarly journals Psychiatrists' letters to general practitioners: choosing the right format

1993 ◽  
Vol 17 (7) ◽  
pp. 414-415 ◽  
Author(s):  
R. G. Pether ◽  
B. A. Johnson ◽  
G. O'Donoghue ◽  
J. Connolly
Keyword(s):  
General Practitioners ◽  
Suicide Risk ◽  
Risk Treatment ◽  
The Right ◽  
Treatment Prognosis

Letters from psychiatrists to general practitioners (GPs) should provide an appropriate content in a format which is easy to write and assimilate. For content, GPs have requested “key items” (diagnosis, suicide risk, treatment, prognosis and follow-up), and an explanation which is educational (Williams & Wallace, 1974; Pullen & Yellowlees, 1985; Margo, 1982). For format, GPs preferred a one page letter with two or three sub-headings in a survey based on one fictitious case (Yellowless & Pullen, 1984). Real letters from psychiatrists in one district averaged one and three quarter pages with four subheadings (Prasher et al, 1992). GPs' opinions about actual changes in the format and content of letters sent to them have not been reported.

scholarly journals Perinatal circumstances and risk of offspring suicide

2006 ◽  
Vol 189 (6) ◽  
pp. 502-507 ◽  
Author(s):  
Daniel V. Riordan ◽  
Sivasubramaniam Selvaraj ◽  
Cameron Stark ◽  
Julie S. E. Gilbert
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Linked Data ◽  
Maternal Age ◽  
Suicide Risk ◽  
Cox Regression ◽  
Maternal Parity ◽  
Self Harm ◽  
Independent Association ◽  
The Relationship

BackgroundA higher risk of suicide has been associated with low birth weight in one study, but not yet replicated. Higher birth order has been associated with self-harm, but not with suicide.AimsTo examine the relationship between perinatal circumstances and subsequent young adult suicide in Scotland.MethodUsing linked data from the Scottish Morbidity Record and Scottish death records, a birth cohort of 1 061 830 people was followed-up for a mean of 25.1 years. Data were analysed using Cox regression.ResultsHigher maternal parity, younger maternal age (<25 years), non-professional parental occupations and low birth weight (<2500 g) were independently associated with higher suicide risk of offspring as young adults. There was no independent association with gestational age.ConclusionsOur findings provide support for the influence of maternal circumstance and foetal experience on subsequent mental health.

We didn’t see it coming! Managerial challenges in silently fading processes

2014 ◽  
Vol 32 (6) ◽  
pp. 534-550 ◽  
Author(s):  
Helena Renström
Keyword(s):  
General Tendency ◽  
Financial Advisors ◽  
Structured Interviews ◽  
Content Type ◽  
Process Dynamics ◽  
Unstable Phase ◽  
Constructive Dialogue ◽  
The Right ◽  
Private Banking ◽  
The Relationship

Purpose – The purpose of this paper is to understand “silent” processes, where the relationship fades away for no obvious reason, and to outline a few managerial challenges related to a passive engagement style in the relationship. Design/methodology/approach – This paper uses an exploratory approach where 42 interviews were screened, resulting in eight semi-structured interviews that were used describing silent fading relationships. The interviews represent four relationship dyads between financial advisors and their customers in a private banking setting (wealth management). Findings – The paper outlines the relationship roots, the process dynamics, and the reasons behind fading in the relationships. It emphasizes the problems with implicit expectations from both parties in the relationship and suggests that more focus should be put on defining the relationship from the start. The absence of interaction and dialogue is problematic. If the parties in the relationship are able to communicate constructively during an unstable phase in the relationship, there is a better chance that the relationship will survive. Research limitations/implications – Since no attempts are made to generalize the knowledge retrieved, the number of fading relationships categorized must not be seen as representative for a general tendency. Practical implications – The paper offers several managerial challenges when it comes to understanding the management of silently fading relationships, e.g. managing mismatching expectations, defining and re-defining the relationship, constructive dialogue, gaining service encounter information, and the need for finding the right level of commitment in the relationship. Originality/value – This paper discusses several concepts that are highly interesting for research related to relationship dynamics. Most studies have focussed on active decisions in relationships, whereas this paper focusses on passive and inactive decisions. It also offers empirical insights, which are scarce in the area.

scholarly journals Systemic inflammation and suicide risk: cohort study of 419 527 Korean men and women

2018 ◽  
Vol 72 (7) ◽  
pp. 572-574 ◽  
Author(s):  
G David Batty ◽  
Keum Ji Jung ◽  
Sunmi Lee ◽  
Joung Hwan Back ◽  
Sun Ha Jee
Keyword(s):  
Systemic Inflammation ◽  
Suicide Risk ◽  
Positive Association ◽  
Suicide Mortality ◽  
Risk Of Death ◽  
Induced Mood ◽  
Increase Risk ◽  
Strong Positive Association ◽  
The Relationship ◽  
Mortality Surveillance

BackgroundData from only one study have been used to examine the relationship between systemic inflammation and later suicide risk, and a strong positive association was apparent. More research is needed, particularly looking at gender, not least because women are seemingly more vulnerable to inflammation-induced mood changes than men.MethodsThe Korean Cancer Prevention Study had a cohort of over 1 million individuals aged 30–95 years at baseline examination between 1992 and 1995, when white blood cell count, our marker of systemic inflammation, was assessed.ResultsA mean of 16.6 years of mortality surveillance gave rise to 1010 deaths from suicide in 106 643 men, and 1019 deaths from suicide in 312 884 women. There was little evidence of an association between our inflammation marker and suicide mortality in men after multiple adjustments. In women, however, those in the second inflammation quartile and higher experienced around 30% increase risk of death (HR 1.35; 95% CI: 1.11–1.64).ConclusionsHigher levels of systemic inflammation were moderately related to an elevated risk of suicide death in women but not in men.

scholarly journals The effect of therapeutic phlebotomy for hemochromatosis on non-suicidal self-injury: A case report

2018 ◽  
Vol 54 (1) ◽  
pp. 74-79
Author(s):  
Benjamin JC Newham ◽  
Rahul Khanna
Keyword(s):  
Risk Assessment ◽  
Case Report ◽  
Adverse Outcomes ◽  
Case Presentation ◽  
First Report ◽  
Self Injury ◽  
Assessment And Monitoring ◽  
Self Harm ◽  
The Relationship

Background Self-phlebotomy has been described as a form of non-suicidal self-injury. However, a relationship between non-suicidal self-injury and therapeutic phlebotomy for hemochromatosis has not previously been described. Case presentation: We present a case of a 52-year-old man in whom the frequency of his therapeutic phlebotomy and non-suicidal self-injury were inversely linked, leading to adverse outcomes when his phlebotomy was suspended. Conclusions This is the first report describing the relationship between non-suicidal self-injury and therapeutic phlebotomy. This case highlights the need for risk assessment and monitoring of self-harm in patients who are undergoing therapeutic phlebotomy in order to prevent adverse outcomes.

A study of suicidal attempts and voluntary self-harm admitted to “Al. Obregia” psychiatry clinical hospital between 2008 and 2010

2011 ◽  
Vol 26 (S2) ◽  
pp. 1627-1627
Author(s):  
M. Manea ◽  
V. Rusanu ◽  
B.E. Patrichi ◽  
A.A. Frunza ◽  
S.M. Bectas ◽  
...  
Keyword(s):  
Suicide Risk ◽  
Psychiatric Patients ◽  
Seasonal Pattern ◽  
Suicide Risk Assessment ◽  
Prevention Strategies ◽  
Number Of Children ◽  
Icd 10 ◽  
Self Harm ◽  
The Relationship ◽  
Risk Assessment And Management

IntroductionIn 2009, 8 Romanians committed suicide every day. Suicide risk assessment and management remains difficult for psychiatrists worldwide and requires further study and a better implementation of prevention strategies.AimsTo identify the relationship between demographic and clinical data in a sample of psychiatric patients admitted after a suicideattempt and voluntary self-harm (VSH-SA) to our hospital between 2008 and 2010.ObjectivesThe purpose of this study is to determine which factors, if any, influence suicidal behavior.MethodsA retrospective review of patients aged 10–84 with VSH-SA (coded by ICD-10), admitted during a three year period. The cases were sorted by age, gender, year of admission, seasonal pattern, mechanism of injury and associated psychiatric pathology. The mechanisms of injury were both violent and non-violent.Results59% of cases were female and 41% male, 18% under the age of 18 (82% female). 31,5% were in the 18-29 years of age interval. A large difference between the year 2008 (16 cases) and 2009 (51 cases) was registered in the male group. Most cases were registered during spring (34%). Drug and substance ingestion was the most common method. Violent methods were used by 25% of men and only 9,5% of women. The most frequent diagnosis was major depression.ConclusionOur results show that a large number of VSH-SA were committed by young, active members of the population and a significant number of children was noticed. These findings emphasize the importance of identifying suicide risk factors and developing prevention strategies.

scholarly journals Social-family development: integral culture for the formation of the children of the zero program always in the municipality of Pamplona

2019 ◽  
Vol 11 (11) ◽  
pp. 31-43
Author(s):  
Fredy Andrés Cruz - Vega ◽  
Luz Eliana Figueroa - Granados
Keyword(s):  
Rural Areas ◽  
Primary Objective ◽  
Point Of View ◽  
Structured Interviews ◽  
The Social ◽  
The Right ◽  
Relationship Of ◽  
The Impact ◽  
The Relationship

The research makes it possible to recognize the judgments of the users who are enrolled in the zero to always family modality and, in turn, establish the relationship they give to the program in the training of their children. The use of qualitative research for this proposal contributes or it establishes the relationship of describing and giving points of view to problems of the social educational and experiential context, the primary objective was to determine the degree of use by users of the program from zero to always family modality, in the municipality of Pamplona. It can be said that the application of this research contributes in part to diagnosing from a personal point of view the impact generated by the program in the training of minors, evidencing in it the theoretical, political and real positions in order to make them aware of the importance of training of children. The instruments used for families in certain rural areas who are the objects of study were semi-structured interviews; validated by experts from the area, they managed to produce key information for the analysis and triangulation. Thanks to the analysis units and the categories established in the interview, it was possible to focus and provide solutions to the objectives set, demonstrating the perception that the beneficiaries of the program of zero They always have in relation to the operation in rural areas of Pamplona. With the information obtained it is clear to establish the conformity of the operation of the program in terms of the role of care for families, the training of minors and the integration of society is thus how the show is getting on the right tide.

scholarly journals How accurate are suicide risk prediction models? Asking the right questions for clinical practice

2019 ◽  
Vol 22 (3) ◽  
pp. 125-128 ◽  
Author(s):  
Daniel Whiting ◽  
Seena Fazel
Keyword(s):  
Machine Learning ◽  
Clinical Practice ◽  
Suicide Risk ◽  
Potential Role ◽  
Prediction Models ◽  
Learning Approaches ◽  
Risk Prediction Models ◽  
Self Harm ◽  
The Right

Prediction models assist in stratifying and quantifying an individual’s risk of developing a particular adverse outcome, and are widely used in cardiovascular and cancer medicine. Whether these approaches are accurate in predicting self-harm and suicide has been questioned. We searched for systematic reviews in the suicide risk assessment field, and identified three recent reviews that have examined current tools and models derived using machine learning approaches. In this clinical review, we present a critical appraisal of these reviews, and highlight three major limitations that are shared between them. First, structured tools are not compared with unstructured assessments routine in clinical practice. Second, they do not sufficiently consider a range of performance measures, including negative predictive value and calibration. Third, the potential role of these models as clinical adjuncts is not taken into consideration. We conclude by presenting the view that the current role of prediction models for self-harm and suicide is currently not known, and discuss some methodological issues and implications of some machine learning and other analytic techniques for clinical utility.

scholarly journals Working with Young People at Risk of Suicidal Behaviour and Self-Harm: A Qualitative Study of Australian General Practitioners’ Perspectives

2021 ◽  
Vol 18 (24) ◽  
pp. 12926
Author(s):  
India Bellairs-Walsh ◽  
Sadhbh J. Byrne ◽  
Sarah Bendall ◽  
Yael Perry ◽  
Karolina Krysinska ◽  
...  
Keyword(s):  
At Risk ◽  
Young People ◽  
Qualitative Study ◽  
General Practitioners ◽  
Suicidal Behaviour ◽  
Assessment Tools ◽  
Service Access ◽  
Structured Interviews ◽  
Mental Health Support ◽  
Self Harm

General Practitioners (GPs) play a crucial role in the identification and support of young people at risk of suicidal behaviour and self-harm; however, no studies have explored GPs’ perspectives, approaches, challenges, and resource needs when working with this cohort in an Australian setting. This was a qualitative study where fifteen GPs (Mage = 45.25 years) from multiple clinics in Western Australia took part in semi-structured interviews, and data were analysed thematically. Seven main themes were identified: (1) working with young people has its unique challenges; (2) screening and assessment tools can help to manage uncertainty and discomfort; (3) going beyond tools–the dialogue and relationship are most important; (4) there are limits to what we can offer in the time available; (5) the service access and referral pathways lack clarity and coordination; (6) the provision of mental health support should not fall on GPs alone; and (7) more comprehensive training in suicide and self-harm is needed. The findings highlight a number of opportunities to enhance care and better assist GPs working with young people who present with suicidal behaviour and self-harm, including considerations for conducting assessments, targeted resources such as training, and system and service improvements.

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