Harm minimisation for self-harm: a cross-sectional survey of British clinicians' perspectives and practices.
BMJ Open
; 12(6): e056199, 2022 06 03.
Article
em En
| MEDLINE
| ID: mdl-35980724
ABSTRACT
OBJECTIVE:
Harm minimisation for self-harm is an alternative to preventive strategies and focuses on maximising safety when self-harming. We explored the views of clinicians on harm minimisation for self-harm to describe reported use and acceptability in clinical practice.DESIGN:
A cross-sectional study using an online survey consisting of fixed-choice and open-ended questions.SETTING:
Primary and secondary care practices in England, Scotland and Wales.PARTICIPANTS:
Snowball sampling of UK-based clinicians (n=90; 67% female) working with people who self-harm and who have or have not previously recommended harm minimisation methods to patients.RESULTS:
Of the 90 clinicians sampled, 76 (84%) reported having recommended harm minimisation techniques to people in their care who self-harm. Commonly recommended techniques were snapping rubber bands on one's wrist and squeezing ice. Other techniques, such as teaching use of clean instruments when self-harming, were less likely to be recommended. Perceived client benefits included harm reduction and promotion of the therapeutic relationship. Perceived potential limitations of a harm minimisation approach for self-harm were (a) potential worsening of self-harm outcomes; (b) ethical reservations; (c) doubts about its effectiveness and appropriateness; and (d) lack of training and clear policies within the workplace.CONCLUSIONS:
In our sample of UK-based clinicians in various settings, harm minimisation for self-harm was broadly recommended for clients who self-harm due to perceived client benefits. However, future policies on harm minimisation must address clinicians' perceived needs for training, well-defined guidelines, and clear evidence of effectiveness and safety to mitigate some clinician concerns about the potential for further harm.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
1_ASSA2030
Base de dados:
MEDLINE
Assunto principal:
Comportamento Autodestrutivo
/
Redução do Dano
Tipo de estudo:
Guideline
/
Observational_studies
/
Prevalence_studies
/
Qualitative_research
/
Risk_factors_studies
Aspecto:
Ethics
Limite:
Female
/
Humans
/
Male
Idioma:
En
Revista:
BMJ Open
Ano de publicação:
2022
Tipo de documento:
Article