Service use in adolescents at risk of depression and self-harm: prospective longitudinal study

Sayal, Kapil; Yates, Nichola; Spears, Melissa; Stallard, Paul

doi:10.1007/s00127-014-0843-y

Cited by 20 publications

(19 citation statements)

References 37 publications

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“…Older adolescents are more likely to initiate help-seeking in their own right. The higher rate of primary care contact for SH in older adolescents may be partially attributable to an increase in help-seeking with age 33…”

Section: Discussionmentioning

confidence: 99%

Self-harm presentation across healthcare settings by sex in young people: an e-cohort study using routinely collected linked healthcare data in Wales, UK

et al. 2019

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BackgroundThis study used individual-level linked data across general practice, emergency departments (EDs), outpatients and hospital admissions to examine contacts across settings and time by sex for self-harm in individuals aged 10–24 years old in Wales, UK.MethodsA whole population-based e-cohort study of routinely collected healthcare data was conducted. Rates of self-harm across settings over time by sex were examined. Individuals were categorised based on the service(s) to which they presented.ResultsA total of 937 697 individuals aged 10–24 years contributed 5 369 794 person years of data from 1 January 2003 to 30 September 2015. Self-harm incidence was highest in primary care but remained stable over time (incident rate ratio (IRR)=1.0; 95% CI 0.9 to 1.1). Incidence of ED attendance increased over time (IRR=1.3; 95% CI 1.2 to 1.5) as did hospital admissions (IRR=1.4; 95% CI 1.1 to 1.6). Incidence in the 15–19 years age group was the highest across all settings. The largest increases were seen in the youngest age group. There were increases in ED attendances for both sexes; however, females are more likely than males to be admitted following this. This was most evident in individuals 10–15 years old, where 76% of females were admitted compared with just 49% of males. The majority of associated outpatient appointments were under a mental health specialty.ConclusionsThis is the first study to compare self-harm in people aged 10–24 years across primary care, EDs and hospital settings in the UK. The high rates of self-harm in primary care and for young men in EDs highlight these as important settings for intervention.

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Section: Discussionmentioning

confidence: 99%

Self-harm presentation across healthcare settings by sex in young people: an e-cohort study using routinely collected linked healthcare data in Wales, UK

et al. 2019

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“…It is important therefore that the issues relating to service access and use are considered in future research. A survey of UK adolescents at high risk of self‐harm found that few had accessed specialist mental health services but that the majority had seen their general practitioner during the preceding six months (Sayal, Yates, Spears & Sallard, ). Furthermore, research indicates that alexithymia is significantly associated with high use of health care services and frequent reporting of symptoms (Lumley, ).…”

Section: Discussionmentioning

confidence: 99%

The relationship between self‐harm and alexithymia

Norman

Borrill

2015

Scandinavian J Psychology

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This paper presents a systematic review of the literature concerning the relationship between alexithymia and self-harm. Fifteen studies were selected following a systematic search of relevant databases. Results indicate significantly higher levels of alexithymia in women who self-harm compared with women who do not self-harm. Studies of men were less conclusive and require further investigation. A subsample of the studies found that childhood abuse and bullying were more likely to be associated with self-harm if alexithymia was present as a mediator. Other studies found that depression mediated between alexithymia and self-harm. The results indicate that the poor emotional cognition and expression associated with alexithymia may increase vulnerability to self-harm, particularly in women.

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“…18 Additionally, 58% of young people who engage in self-harm had seen their GP in the previous 6 months. 20 As such, primary care presents a valuable opportunity for the identification, response to, and management of signs of suicidal behaviour and self-harm in young people. 21 Training standards for general practice recommend that GPs are able to identify warning signs and risk factors for suicide and respond appropriately.…”

Section: Open Accessmentioning

confidence: 99%

Best practice when working with suicidal behaviour and self-harm in primary care: a qualitative exploration of young people’s perspectives

et al. 2020

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ObjectivesGeneral practitioners (GPs) have a key role in supporting young people who present with suicidal behaviour/self-harm. However, little is known about young people’s opinions and experiences related to GPs’ practices for such presentations, and their decisions to disclose suicidal behaviour/self-harm to GPs. Additionally, existing guidelines for the management of suicide risk and/or self-harm have not incorporated young people’s perspectives. This study aimed to explore young people’s views and experiences related to the identification, assessment and care of suicidal behaviour and self-harm in primary care settings with GPs.Design, setting and participantsTwo qualitative focus groups were conducted in Perth, Western Australia, with 10 young people in total (Mage = 20.67 years; range: 16–24). Data were collected using a semistructured, open-ended interview schedule and analysed using thematic analysis.ResultsFive major themes were identified from the focus groups. (1) Young people wanted a collaborative dialogue with GPs, which included being asked about suicidal behaviour/self-harm, informed of treatment processes and having autonomy in decision making; (2) young people were concerned with a loss of privacy when disclosing suicidal behaviour/self-harm; (3) young people viewed labels and assessments as problematic and reductionist—disliking the terms ‘risk’ and ‘risk assessment’, and assessment approaches that are binary and non-holistic; (4) young people highlighted the importance of GPs’ attitudes, with a genuine connection, attentiveness and a non-judgemental demeanour seen as paramount; and (5) young people wanted to be provided with practical support and resources, followed-up, and for GPs to be competent when working with suicidal behaviour/self-harm presentations.ConclusionsOur study identified several concerns and recommendations young people have regarding the identification, assessment and care of suicidal behaviour/self-harm in primary care settings. Taken together, these findings may inform the development of resources for GPs, and support progress in youth-oriented best practice.

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Service use in adolescents at risk of depression and self-harm: prospective longitudinal study

Cited by 20 publications

References 37 publications

Self-harm presentation across healthcare settings by sex in young people: an e-cohort study using routinely collected linked healthcare data in Wales, UK

Self-harm presentation across healthcare settings by sex in young people: an e-cohort study using routinely collected linked healthcare data in Wales, UK

The relationship between self‐harm and alexithymia

Best practice when working with suicidal behaviour and self-harm in primary care: a qualitative exploration of young people’s perspectives

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