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.

Information-Seeking on the Internet

Crisis ◽  
2015 ◽  
Vol 36 (3) ◽  
pp. 211-219 ◽  
Author(s):  
Vinod Singaravelu ◽  
Anne Stewart ◽  
Joanna Adams ◽  
Sue Simkin ◽  
Keith Hawton
Keyword(s):  
At Risk ◽  
Young People ◽  
Information Seeking ◽  
Significant Proportion ◽  
The Internet ◽  
Search Terms ◽  
Specific Advice ◽  
Restriction Sites ◽  
Self Harm ◽  
Negative Tone

Abstract. Background: The Internet is used by young people at risk of self-harm to communicate, find information, and obtain support. Aims: We aimed to identify and analyze websites potentially accessed by these young people. Method: Six search terms, relating to self-harm/suicide and depression, were input into four search engines. Websites were analyzed for access, content/purpose, and tone. Results: In all, 314 websites were included in the analysis. Most could be accessed without restriction. Sites accessed by self-harm/suicide search terms were mostly positive or preventive in tone, whereas sites accessed by the term ways to kill yourself tended to have a negative tone. Information about self-harm methods was common with specific advice on how to self-harm in 15.8% of sites, encouragement of self-harm in 7.0%, and evocative images of self-harm/suicide in 20.7%. Advice on how to get help was given in 56.1% of sites. Conclusion: Websites relating to suicide or self-harm are easily accessed. Many sites are potentially helpful. However, a significant proportion of sites are potentially harmful through normalizing or encouraging self-harm. Enquiry regarding Internet use should be routinely included while assessing young people at risk.

Complicated grief knowledge and practice: a qualitative study of general practitioners in Ireland

2021 ◽  
pp. 1-6
Author(s):  
Abiola Muhammed ◽  
Anne Dodd ◽  
Suzanne Guerin ◽  
Susan Delaney ◽  
Philip Dodd
Keyword(s):  
Qualitative Study ◽  
General Practitioners ◽  
Current Knowledge ◽  
Complicated Grief ◽  
Phenomenological Approach ◽  
Structured Interviews ◽  
Relevant Research ◽  
Loved One ◽  
Knowledge And Practice ◽  
Purposive Sample

Objective: Complicated grief is a debilitating condition that individuals may experience after losing a loved one. General practitioners (GPs) are well positioned to provide patients with support for grief-related issues. Traditionally, Irish GPs play an important role in providing patients with emotional support regarding bereavement. However, GPs have commonly reported not being aptly trained to respond to bereavement-related issues. This study explores GPs’ current knowledge of and practice regarding complicated grief. Methods: A qualitative study adopting a phenomenological approach to explore the experiences of GPs on this issue. Semi-structured interviews were carried out with a purposive sample of nine GPs (five men and four women) in Ireland. Potential participants were contacted via email and phone. Interviews were audio-recorded, transcribed and analysed using Braun & Clarke’s (2006) model of thematic analysis. Results: GPs had limited awareness of the concept of complicated grief and were unfamiliar with relevant research. They also reported that their training was either non-existent or outdated. GPs formed their own knowledge of grief-related issues based on their intuition and experiences. For these reasons, there was not one agreed method of how to respond to grief-related issues reported by patients, though participants recognised the need for intervention, onward referral and review. Conclusions: The research highlighted that GPs felt they required training in complicated grief so that they would be better able to identify and respond to complicated grief.

Models for Integrating Medical Acupuncture into Practice: An Exploratory Qualitative Study of Physicians— Experiences

2016 ◽  
Vol 34 (4) ◽  
pp. 280-289 ◽  
Author(s):  
Ellen T Crumley
Keyword(s):  
Qualitative Study ◽  
General Practitioners ◽  
Full Time ◽  
Snowball Sampling ◽  
Core Concept ◽  
Structured Interviews ◽  
The Core ◽  
Individual Physician ◽  
Part Time ◽  
Medical Acupuncture

Background Internationally, physicians are integrating medical acupuncture into their practice. Although there are some informative surveys and reviews, there are few international, exploratory studies detailing how physicians have accommodated medical acupuncture (eg, by modifying schedules, space and processes). Objective To examine how physicians integrate medical acupuncture into their practice. Methods Semi-structured interviews and participant observations of physicians practising medical acupuncture were conducted using convenience and snowball sampling. Data were analysed in NVivo and themes were developed. Despite variation, three principal models were developed to summarise the different ways that physicians integrated medical acupuncture into their practice, using the core concept of ‘helping’. Quotes were used to illustrate each model and its corresponding themes. Results There were 25 participants from 11 countries: 21 agreed to be interviewed and four engaged in participant observations. Seventy-two per cent were general practitioners. The three models were: (1) appointments (44%); (2) clinics (44%); and (3) full-time practice (24%). Some physicians held both appointments and regular clinics (models 1 and 2). Most full-time physicians initially tried appointments and/or clinics. Some physicians charged to offset administration costs or compensate for their time. Discussion Despite variation within each category, the three models encapsulated how physicians described their integration of medical acupuncture. Physicians varied in how often they administered medical acupuncture and the amount of time they spent with patients. Although 24% of physicians surveyed administered medical acupuncture full-time, most practised it part-time. Each individual physician incorporated medical acupuncture in the way that worked best for their practice.

scholarly journals Assessing young people who deliberately harm themselves

2000 ◽  
Vol 176 (2) ◽  
pp. 126-131 ◽  
Author(s):  
Jane Hurry ◽  
Pamela Storey
Keyword(s):  
At Risk ◽  
Young People ◽  
Service Management ◽  
Postal Questionnaire ◽  
Psychosocial Assessment ◽  
Old Patients ◽  
Admission Rates ◽  
Accident And Emergency ◽  
Patients At Risk ◽  
Self Harm

BackgroundMany young people who harm themselves have chronic mental health or social problems or are at risk of future self-harm or even suicide. The accident and emergency (A&E) clinic is an important gateway to treatment.AimsTo describe the psychosocial assessment of 12- to 24-year-old patients attending A&E clinics following deliberate self-harm (DSH) and to identify features of service management and provision which maximise specialist assessment.MethodA postal questionnaire was sent to a sample of one in three A&E departments in England. In a representative sample of 18 of these hospitals, staff were interviewed and 50 case notes per hospital were examined.ResultsPsychosocial assessment by non-specialist doctors in A&E departments tended to be of variable quality, focused on short-term risk. Around 43% of patients aged 12–24 were assessed by a specialist; specialist assessment was associated with high admission rates and the presence of on-site psychiatric departments and DSH teams.ConclusionsYoung DSH patients at risk often go unidentified; as a result their psychological problems may not be treated. Hospitals are frequently unaware of the proportion of patients discharged without adequate assessment.

Self-harm: A guide for schools on how to respond

2019 ◽  
Vol 14 (6) ◽  
pp. 295-297
Author(s):  
Charlie Waller
Keyword(s):  
At Risk ◽  
Young People ◽  
School Nurses ◽  
School Staff ◽  
Staff Members ◽  
University Of Oxford ◽  
Self Harm ◽  
The University

A guide from the University of Oxford and the Charlie Waller Memorial Trust offers practical ways in which schools can support young people at risk from self-harm, which school nurses can share with school staff members to help them respond.

scholarly journals General practitioners’ concepts on issuing out-of-pocket prescriptions for hypnotics and sedatives in Germany

2019 ◽  
Vol 36 (6) ◽  
pp. 785-790
Author(s):  
Katharina Schmalstieg-Bahr ◽  
Christiane A Müller ◽  
Eva Hummers
Keyword(s):  
Health Insurance ◽  
Qualitative Study ◽  
General Practitioners ◽  
Statutory Health Insurance ◽  
Medication Use ◽  
Hypnotics And Sedatives ◽  
Structured Interviews ◽  
Medication Costs ◽  
Prescription Form ◽  
To Receive

Abstract Background In Germany, almost 50% of prescriptions for benzodiazepines and drugs as Zolpidem and Zopiclone are as out-of-pocket (OOP) prescriptions—requiring patients to buy the drug at their own expense—although almost 90% of the population has statutory health insurance covering medication costs. Objective To understand why general practitioners (GPs) choose this prescribing method since needed medications are insurance covered, and unnecessary drugs should not be prescribed at all. Methods In this qualitative study, 17 semi-structured interviews with GPs were conducted, audio recorded and transcribed verbatim. Transcripts were analysed with grounded theory to extract a model explaining the described behaviour. Results Knowing the significant medical risks and insecurity about regulations makes GPs wish to avoid hypnotics and sedatives. They achieve this by ‘Creating a barrier’ (central phenomenon) and employing the strategy ‘Using an out-of-pocket prescription’, which not only generates costs for the patient but also reduces the physicians´ legal and financial accountability. The perceived patient type, expected problem duration and diagnosis influence the decision about the prescription form: patients with an alcohol or drug addiction or those with ‘uncomplicated’ insomnia are more likely to receive an OOP prescription. Patients with any psychiatric diagnosis will likely receive a statutory health insurance prescription. Discussion Current regulations do not provide guidance to GPs regarding hypnotics and sedatives. A clear regulatory framework and guidelines could possibly reduce physicians’ defensive attitudes about these drugs and their use of OOP prescriptions. The approach to use OOP prescriptions as a barrier to reduce patients’ medication use lacks evidence regarding effectiveness.

scholarly journals The challenges of managing self-harm effectively

2009 ◽  
Vol 15 (6) ◽  
pp. 442-443
Author(s):  
Nisha Dogra
Keyword(s):  
At Risk ◽  
Young People ◽  
Frontline Staff ◽  
What Works ◽  
Specialist Services ◽  
Self Harm

SummaryThis commentary discusses how much we appear to know about self-harm and the circumstances in which it may occur but how little we really know about what works in managing it. It reviews how suggestions for its management conflict with what we know about self-harm and the outcomes of young people. The challenge appears to be how better to identify those at risk of further self-harm and to train frontline staff in this, so that at-risk individuals may be referred to specialist services. Perhaps there is also a need to review the evidence for what actually works in reducing repetition of self-harm.

scholarly journals Aspects associated with waterpipe smoking in Iranian youths: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hamid Jafaralilou ◽  
Arman Latifi ◽  
Mehdi Khezeli ◽  
Atefeh Afshari ◽  
Farahnaz Zare
Keyword(s):  
Young People ◽  
Qualitative Study ◽  
Social Relations ◽  
Eastern Mediterranean ◽  
Waterpipe Smoking ◽  
Structured Interviews ◽  
Face To Face ◽  
Cultural Aspects ◽  
Mediterranean Countries ◽  
Second Category

Abstract Background Waterpipe is one of the oldest methods of tobacco smoking, which has become the public health challenge, especially in the Eastern Mediterranean countries such as Iran. This study aimed to investigate the waterpipe smoking (WPS) in the young people of Kermanshah in 2020, using a qualitative method. Methods This was a qualitative study conducted with the approach of content analysis. Participants were young waterpipe user aged 17 to 25 years selected by purposeful sampling method in Kermanshah city, located in the west of Iran. Data were collected through semi-structured interviews in face-to-face and audio-recorded methods based on an interview guideline during June to August 2020. Then researchers transcribed verbatim and analyzed the content of the interviews thematically. Results In this study, 23 young people who were waterpipe users at the time of the study participated. The results showed that social aspects in three sub-categories were involved in WPS including “socio-cultural aspects”, “socio-environmental aspects”, and “social relations”. Individual aspects of waterpipe use as second category also consisted of two sub-categories including “motivational aspects” and “lack of psycho-protective aspects”. Conclusions It seems that the implementation of the policy of reducing access to waterpipe in public environments is effective in reducing waterpipe consumption. It is suggested that educational and interventions, based on targeted models and theories be implemented in order to increase young people’s belief and perception on dangers of WPS, and to improve their self-efficacy to smoking cessation.

Self-help organisations: A qualitative study of successful collaboration with general practice

2003 ◽  
Vol 9 (3) ◽  
pp. 75 ◽  
Author(s):  
Frances M Boyle ◽  
T. Natasha Posner ◽  
Christopher B Del Mar ◽  
Jill McLean ◽  
Robert A Bush
Keyword(s):  
Health Care ◽  
General Practice ◽  
Qualitative Study ◽  
General Practitioners ◽  
Health Care System ◽  
Cross Section ◽  
Structured Interviews ◽  
Self Help ◽  
Successful Collaboration ◽  
Two Sectors

Thousands of self-help organisations (SHOs) exist in Australia but little is known about how they relate to the mainstream health care system. This qualitative study, based in south-east Queensland, aimed to identify examples of collaboration between general practitioners (GPs) and SHOs in order to examine the attributes of successful partnerships. Representatives of six SHOs, identified by key informants as having good collaborative links with GPs, and seven GPs with whom they collaborated, completed semi-structured interviews. The interviews focused on evidence of collaboration and perceptions of benefits and barriers experienced. Maximum variation sampling enabled a cross-section of SHOs in terms of size, funding, and health issue. Although GPs readily identified SHO benefits, they referred patients to them only rarely. SHO credibility, evidence of tangible benefits for patients, ease of contacting the SHO, and correspondence between the SHO?s focus and the GP?s personal and professional interests appear to contribute to the success of partnerships. We conclude that mutually beneficial partnerships between GPs and SHOs exist but are under-utilised. A more coordinated effort is needed to strengthen links between the two sectors.

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