Anne PF Wand1, Carmelle Peisah2, Brian Draper3, Henry Brodaty4. 1. FRANZCP, Staff Specialist Psychiatrist, Academic Department of Aged Care Psychiatry, Prince of Wales Hospital, Sydney, NSW; Conjoint Senior Lecturer, Discipline of Psychiatry, School of Medicine, University of New South Wales, Sydney, NSW. 2. FRANZCP, Conjoint Professor, Discipline of Psychiatry, School of Medicine, University of New South Wales, Sydney; Clinical Professor, Discipline of Psychiatry, Sydney Medical School, University of Sydney, Sydney, NSW; President, Capacity Australia, Crows Nest, NSW. 3. FRANZCP, Senior Staff Specialist Psychiatrist, Academic Department of Aged Care Psychiatry, Prince of Wales Hospital, Sydney, NSW; Conjoint Professor, Discipline of Psychiatry, School of Medicine, University of New South Wales, Sydney, NSW. 4. FRANZCP, RACP, Scientia Professor, Dementia Collaborative Research Centre and Centre for Healthy Brain Ageing, University of New South Wales, Sydney, NSW.
Abstract
Background and objectives: Little is known about how general practitioners (GPs) conceptualise self-harm in older people. The aim of this study was to explore GPs' understanding of the reasons for recent self-harm in an older patient. Method: Short questionnaires were sent to the GPs of patients aged 80 years or older who had recently self-harmed and were participants in a qualitative study about self-harm. Questions evaluated GPs’ understanding of the self-harm. Thematic analysis was used to identify and analyse themes. Results: Thirteen GP responses were analysed. GPs could identify multiple factors contributing to self-harm in their patients but did not see a role for themselves in addressing these issues. They feared repetition of self-harm if these underlying contributory factors, including depression, did not change. Discussion: Targeted education and practical options for GPs regarding management of the issues underlying self-harm in older people are needed. Families and carers may be underused allies in management. These strategies may serve to counter therapeutic nihilism and clinician isolation.
Background and objectives: Little is known about how general practitioners (GPs) conceptualise self-harm in older people. The aim of this study was to explore GPs' understanding of the reasons for recent self-harm in an older patient. Method: Short questionnaires were sent to the GPs of patients aged 80 years or older who had recently self-harmed and were participants in a qualitative study about self-harm. Questions evaluated GPs’ understanding of the self-harm. Thematic analysis was used to identify and analyse themes. Results: Thirteen GP responses were analysed. GPs could identify multiple factors contributing to self-harm in their patients but did not see a role for themselves in addressing these issues. They feared repetition of self-harm if these underlying contributory factors, including depression, did not change. Discussion: Targeted education and practical options for GPs regarding management of the issues underlying self-harm in older people are needed. Families and carers may be underused allies in management. These strategies may serve to counter therapeutic nihilism and clinician isolation.