Views of mental health practitioners on spirituality in clinical practice, with special reference to the concepts of spiritually competent practice, Availability and Vulnerability: A qualitative evaluation

Abstract. Background: There is no commonly accepted definition of the term self-harm, and there is an ongoing debate about whether or not it should include acts of attempted suicide. The use of this language in clinical practice has not previously been explored. Aims: To investigate if, and how, practitioners distinguish between acts of self-harm and attempted suicide, and present any implications for practice. Method: We conducted semistructured interviews with a random sample of 18 frontline practitioners from 10 mental health wards and completed a thematic analysis of interview data. Results: Most participants described self-harm and attempted suicide as distinct behaviors. Characteristics of the act, disclosures of intent, and the level of distress observed were commonly used to differentiate between self-harm and attempted suicide. Very few participants believed that people who self-harm may also feel suicidal. Practitioners confidently described two different behaviors, yet self-harm and attempted suicide were often conflated, revealing the challenges and complexities associated with the separation of these acts in clinical practice. Limitations: Clinicians working in other settings or disciplines may have different views. Participants' accounts may not be an accurate representation of what happens in practice. Conclusion: This study adds to a body of evidence which argues against the dichotomous separation of these behaviors into acts of suicidal and nonsuicidal self-harm.Our findings suggest there is no common understanding of the boundaries between self-harm and attempted suicide among frontline clinicians. The language currently used, and consequent practice, particularly with regard to risk assessment, is problematic. Efforts should be made to operationalize terms around suicidal behavior and to incorporate these into training for clinical staff.

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The voice of the child in parental divorce: implications for clinical practice and mental health practitioners

Journal of Child and Adolescent Mental Health ◽

10.2989/17280583.2017.1345746 ◽

2017 ◽

Vol 29 (2) ◽

pp. 169-178 ◽

Cited By ~ 1

Author(s):

Carrie Brand ◽

Greg Howcroft ◽

Christopher Norman Hoelson

Keyword(s):

Mental Health ◽

Clinical Practice ◽

Parental Divorce ◽

Mental Health Practitioners ◽

Health Practitioners ◽

The Voice

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No-Suicide Contracts, No-Suicide Agreements, and No-Suicide Assurances

Crisis ◽

10.1027/0227-5910/a000048 ◽

2010 ◽

Vol 31 (6) ◽

pp. 290-302 ◽

Cited By ~ 21

Author(s):

Stephen J. Edwards ◽

Mark D. Sachmann

Keyword(s):

Mental Health ◽

Clinical Practice ◽

Nurse Practitioners ◽

Response Rate ◽

Mental Health Practitioners ◽

Alternative Interventions ◽

Factors Associated ◽

Mental Health Nurse ◽

Health Practitioners ◽

Health Nurse

Background: Suicide prevention contracting (SPC) procedures are often afforded clinical practice validity in the absence of evidence attesting to their efficacy and validity. Aims: This study sought to develop a contemporary profile of SPC, identifying factors associated with utilization, perceived effectiveness, and to describe potentially detrimental factors when activating SPC. Methods: A questionnaire was mailed to a sample of mental health practitioners comprising physicians, mental health nurse practitioners, and allied health practitioners to inquire about their practices and experiences with SPC. Results: There were 420 valid responses, a response rate of 31%. Participants confirmed three types of SPC procedures in operation: (1) 355 (85%) having used verbal no-suicide assurances (NSAs); (2) 317 (76%) using verbal no-suicide agreements (NSAg); and, (3) 154 (37%) using written no-suicide contracts (NSC). The profiled procedures and their clinical application indicate that participants perceived differences in the diagnostic, therapeutic, and medico-legal utility of all three SPC procedures. Importantly, SPC procedures were shown to have a multifaceted potential for detrimental outcomes for patients and practitioners. Conclusions: Until now, SPC had represented a poorly understood and remains a questionable clinical practice intervention. Education initiatives are required that alert mental health practitioners to the dangers of SPC for patients and practitioners alike, and to present alternative interventions containing less risk.

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