A qualitative study of multiple voices to inform aftercare services for older persons following self‐harm

Wand, Anne; Karageorge, Aspasia; Browne, Roisin; Jessop, Tiffany; Peisah, Carmelle

doi:10.1002/gps.5876

Cited by 3 publications

(1 citation statement)

References 49 publications

(131 reference statements)

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“…Research suggests that healthcare practitioners experience difficulties in recognising self‐harm and mental health problems such as depression, often due to ageism 21 . Similar to findings from this research, previous qualitative research conducted in Australia found that ageism, limited services, funding, and training, often preclude offering of better support for older adults who self‐harm 33 …”

Section: Discussionsupporting

confidence: 72%

Healthcare practitioners' views of self‐harm management practices in older adults in Ireland: A qualitative study

Troya,

Lonergan,

Cassidy

et al. 2024

Int J Geriat Psychiatry

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ObjectivesTo explore healthcare practitioners' views on management practices of self‐harm in older adults.MethodsSemi‐structured interviews were conducted with healthcare practitioners, including consultant psychiatrists, general practitioners, clinical psychologists, psychotherapists, clinical nurse specialists and social workers. Purposeful sampling was used to recruit participants in the Republic of Ireland ensuring diverse perspectives of healthcare practitioners were included. Healthcare practitioners were recruited advertising via professional and clinical research networks, social media, and snowballing methods. Interviews were audio‐recorded, transcribed verbatim, and analysed using reflexive thematic analysis.ResultsWe conducted interviews with 20 healthcare practitioners from April to July 2023. Three main themes were generated: first, a perceived greater risk of suicide, and increased awareness of complexity in older adults' self‐harm presentations. Second, integrated care as an avenue for improving the management of self‐harm in older adults. Third, the importance of safety planning in risk assessments of older adults.ConclusionsHealthcare practitioners viewed self‐harm in older adults as complex, challenging, and associated with high suicide risk, approaching patients with care and caution. The need for integrated support and improved collaboration between relevant healthcare practitioners was identified. Suggestions were made for primary care having a lead role in identifying and managing older adults after self‐harm. Increased mental health promotion and awareness of mental health and self‐harm in this age group would help address current stigma and shame.

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Section: Discussionsupporting

confidence: 72%

Healthcare practitioners' views of self‐harm management practices in older adults in Ireland: A qualitative study

Troya,

Lonergan,

Cassidy

et al. 2024

Int J Geriat Psychiatry

View full text Add to dashboard Cite

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Conceptualizing Self-Harm through the Experiences of Psychogeriatric Experts

Van Hove,

Baetens,

Vanderstichelen

2024

Psychopathology

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Introduction: Fewer studies thus far have focused on self-harm and its specific forms among older adults. Moreover, the limited available literature applies varying terminology. The categorization of self-harm used in younger populations may not be as appropriate for this population. This means that less is known about this phenomenon in older adults. The current study aimed to reduce this gap. Methods: Nine Flemish psychogeriatric experts participated in a semi-structured interview. Transcripts were thematically analyzed. Results: Themes emerging from the interviews suggest that self-harm in older adults may also include distinct elements, such as the omission of certain behaviours and engagement in indirect self-harm to cause bodily harm. According to the experts, self-harm may be engaged in to cope with emotions, express life fatigue, hasten death, and communicate a cry for help. Discussion: Self-harm is prevalent in older adults, and some characteristics may be specific to self-harm in an older age group. These findings may enable clinicians to be more alert to self-harm in older adults and consequently prevent serious suicidal behaviour. More research is needed to further uncover this phenomenon.

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Mortality in people living with dementia who self-harmed: An Australian data linkage study

Walker,

Srasuebkul,

Trollor

et al. 2024

Aust N Z J Psychiatry

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Objectives: This study aimed to examine mortality for people living with dementia/mild cognitive impairment who self-harmed. Methods: We conducted a retrospective cohort study in New South Wales, Australia, using data ranging from 2001 to 2015. From people who accessed hospital services in the study period, we identified 154,811 people living with dementia/mild cognitive impairment, 28,972 who self-harmed and 1511 who had a record of both dementia/mild cognitive impairment and self-harm. We examined rates, causes and predictors of death for people with dementia/mild cognitive impairment and/or self-harm diagnoses using flexible parametric survival analyses. We explored rates of repeat self-harm in people living with dementia who self-harmed. Results: Circulatory disorders accounted for 32.0% of deaths in people with a living with dementia who self-harmed, followed by neoplasms (14.7%), and mental and behavioural disorders (9.6%). Death was more likely for someone who had self-harmed if they developed dementia/mild cognitive impairment. Predictors of death included male sex, greater physical comorbidity, a history of delirium, more previous emergency department presentations and fewer previous mental health ambulatory service days. Greater engagement with outpatient mental health services predicted a decreased likelihood of repeat self-harm. Discussion: We found that mortality increases when people who self-harm develop dementia. We argue post-diagnosis support offers a potential opportunity to reduce mortality rates in people with both dementia and self-harm diagnoses.

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A qualitative study of multiple voices to inform aftercare services for older persons following self‐harm

Cited by 3 publications

References 49 publications

Healthcare practitioners' views of self‐harm management practices in older adults in Ireland: A qualitative study

Healthcare practitioners' views of self‐harm management practices in older adults in Ireland: A qualitative study

Conceptualizing Self-Harm through the Experiences of Psychogeriatric Experts

Mortality in people living with dementia who self-harmed: An Australian data linkage study

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