GPs role identifying young people who self-harm: a mixed methods study

BACKGROUND: Self-harm is common among young people and is evident in increasingly younger age groups. Many young people who self-harm do visit their GP but do not access specialist support. GP’s can find it challenging to raise and discuss this sensitive subject with young people during short consultations. OBJECTIVE: To explore GP’s capabilities, motivations and opportunities for discussing self-harm and to identify barriers to and enablers for proactively discussing self-harm with young people. DESIGN AND SETTING: An exploratory, mixed methods study was designed comprising an online survey and a qualitative interview study with GPs in the South West of England. METHODS: An online survey was completed by 28 GPs. Ten GPs took part by telephone, in semi-structured interviews. Quantitative data was analysed using descriptive statistical techniques and thematic analysis was used to analyse the qualitative data. Findings from the quantitative and qualitative analysis are synthesized to illustrate GPs’ skills, knowledge and perceptions about young people who self-harm. RESULTS: Experienced GPs may underestimate the prevalence of self-harm in young people, particularly in the 11–14 age range. While consultations with young people and their carers can be challenging, GPs acknowledge that it is their role to provide support for young people who self-harm. GPs would welcome training for themselves and other practice staff in talking to young people and practical information about self-harm. CONCLUSION: All primary care staff who provide frontline support to young people should receive education and practical training in talking about self-harm.