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Accessing psychological therapies following self-harm: qualitative survey of patient experiences and views on improving practice

BACKGROUND: Psychological therapies following an episode of self-harm should happen quickly to ensure patients receive the care they need and to reduce the likelihood of repetition. AIMS: We sought to explore patients' subjective experience of accessing psychological therapies following self-ha...

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Autores principales: Quinlivan, Leah, Gorman, Louise, Monaghan, Elizabeth, Asmal, Sadika, Webb, Roger T., Kapur, Nav
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cambridge University Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10134355/
https://www.ncbi.nlm.nih.gov/pubmed/37038765
http://dx.doi.org/10.1192/bjo.2023.27
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author Quinlivan, Leah
Gorman, Louise
Monaghan, Elizabeth
Asmal, Sadika
Webb, Roger T.
Kapur, Nav
author_facet Quinlivan, Leah
Gorman, Louise
Monaghan, Elizabeth
Asmal, Sadika
Webb, Roger T.
Kapur, Nav
author_sort Quinlivan, Leah
collection PubMed
description BACKGROUND: Psychological therapies following an episode of self-harm should happen quickly to ensure patients receive the care they need and to reduce the likelihood of repetition. AIMS: We sought to explore patients' subjective experience of accessing psychological therapies following self-harm and their views on improving practice. METHOD: Between March and November 2019, we recruited 128 patients and 23 carers aged 18 years or over from 16 English mental health trusts, from community organisations and via social media. Thematic analyses were used to interpret the data. RESULTS: Participants reported long waiting times, multiple failed promises and rejection when trying to access psychological therapies following self-harm. Poor communication and information provision contributed to uncertainty, worsening mental health and further self-harm. Other barriers included: lack of tailored interventions, stigmatising responses, use of exclusionary thresholds to access services, and punitive approaches to treating these patients. Participant recommendations to improve access to psychological therapies included: (a) the importance of compassionate and informed staff; (b) having timely access to aftercare from well-funded and well-resourced teams; (c) continuity of care, improved communication, and support during waiting times and while navigating the referral process; (d) greater information on the availability and benefits of psychological therapies; and (e) greater choice and flexibility over interventions. CONCLUSION: Our findings identify long waiting times and inadequate service provision as barriers to high-quality and safe aftercare for patients who have self-harmed. Consistent with clinical guidelines, all patients should receive prompt aftercare and access to tailored psychological treatments following a self-harm episode.
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spelling pubmed-101343552023-04-28 Accessing psychological therapies following self-harm: qualitative survey of patient experiences and views on improving practice Quinlivan, Leah Gorman, Louise Monaghan, Elizabeth Asmal, Sadika Webb, Roger T. Kapur, Nav BJPsych Open Paper BACKGROUND: Psychological therapies following an episode of self-harm should happen quickly to ensure patients receive the care they need and to reduce the likelihood of repetition. AIMS: We sought to explore patients' subjective experience of accessing psychological therapies following self-harm and their views on improving practice. METHOD: Between March and November 2019, we recruited 128 patients and 23 carers aged 18 years or over from 16 English mental health trusts, from community organisations and via social media. Thematic analyses were used to interpret the data. RESULTS: Participants reported long waiting times, multiple failed promises and rejection when trying to access psychological therapies following self-harm. Poor communication and information provision contributed to uncertainty, worsening mental health and further self-harm. Other barriers included: lack of tailored interventions, stigmatising responses, use of exclusionary thresholds to access services, and punitive approaches to treating these patients. Participant recommendations to improve access to psychological therapies included: (a) the importance of compassionate and informed staff; (b) having timely access to aftercare from well-funded and well-resourced teams; (c) continuity of care, improved communication, and support during waiting times and while navigating the referral process; (d) greater information on the availability and benefits of psychological therapies; and (e) greater choice and flexibility over interventions. CONCLUSION: Our findings identify long waiting times and inadequate service provision as barriers to high-quality and safe aftercare for patients who have self-harmed. Consistent with clinical guidelines, all patients should receive prompt aftercare and access to tailored psychological treatments following a self-harm episode. Cambridge University Press 2023-04-11 /pmc/articles/PMC10134355/ /pubmed/37038765 http://dx.doi.org/10.1192/bjo.2023.27 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by-nd/4.0/This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NoDerivatives licence (http://creativecommons.org/licenses/by-nd/4.0), which permits re-use, distribution, and reproduction in any medium, provided that no alterations are made and the original article is properly cited.
spellingShingle Paper
Quinlivan, Leah
Gorman, Louise
Monaghan, Elizabeth
Asmal, Sadika
Webb, Roger T.
Kapur, Nav
Accessing psychological therapies following self-harm: qualitative survey of patient experiences and views on improving practice
title Accessing psychological therapies following self-harm: qualitative survey of patient experiences and views on improving practice
title_full Accessing psychological therapies following self-harm: qualitative survey of patient experiences and views on improving practice
title_fullStr Accessing psychological therapies following self-harm: qualitative survey of patient experiences and views on improving practice
title_full_unstemmed Accessing psychological therapies following self-harm: qualitative survey of patient experiences and views on improving practice
title_short Accessing psychological therapies following self-harm: qualitative survey of patient experiences and views on improving practice
title_sort accessing psychological therapies following self-harm: qualitative survey of patient experiences and views on improving practice
topic Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10134355/
https://www.ncbi.nlm.nih.gov/pubmed/37038765
http://dx.doi.org/10.1192/bjo.2023.27
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