Citation

Mughal F, Clarke L, Connolly R, Lee AYT, Quinlivan L, Kapur N. Br. J. Gen. Pract. 2023; 73(729): 148-149.

Copyright

(Copyright © 2023, Royal College of General Practitioners)

DOI

10.3399/bjgp23X732297

PMID

36997200

PMCID

PMC10049611

Abstract

Self-harm is sometimes seen by health professionals as a minor problem, yet the risk of suicide is increased fifty-fold in the year after a self-harm episode compared to the general population.1 Reducing rates of self-harm is a national policy priority but research suggests that self-harm presentations to general practice are increasing.2 Self-harm is defined as intentional self-injury or poisoning regardless of suicidal intent and can occur at any age.3 In young females, around one in four have a lifetime history of self-harm.4 In older adults who have self-harmed the risk of suicide is particularly high.5 Reliable data about self-harm are relatively sparse because self-harm may be hidden, and even when people do present to clinical services self-harm may be poorly recorded.

It is estimated that there are around 228 000 self-harm hospital presentations each year in England that result in NHS treatment costs of ∼£128 million.6 Even though some people have a single episode of self-harm, around one in five repeat self-harm within 1 year of hospital presentation.7 Self-harm is also a global health issue. A few approaches have been tested internationally to reduce repeat self-harm in primary care: neither an educational intervention for GPs targeting older adults or structured GP follow-up reduced repeat self-harm episodes.8,9

Within the NHS in the UK, the primary care team is now diverse with new roles such as clinical pharmacists and physician associates supporting the delivery of patient care, but GPs remain pivotal in managing patients who have harmed themselves, and in many cases they may be the senior clinician involved.10 Practice nurses describe a lack of confidence managing patients who self-harm.11 The primary care setting can facilitate early self-harm identification and intervention in patients to reduce future …

Language: en