Sometimes, not always, not never: a response to Pickard and Pearce

Sullivan, Patrick

doi:10.1136/medethics-2017-104343

Cited by 3 publications

(2 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These arguments against the use of harm reduction are valid and are important to consider when considering the use of this approach in practice. However, it is important to note that harm reduction is not advocated as a routine measure and is not an approach that will be appropriate for all those who self‐harm (National Collaborating Centre for Mental Health ; Sullivan ). It does not constitute a blanket permission to self‐harm with staff allowing significant harm to occur (Sullivan ), and it is likely that the relevant inpatient population for whom harm reduction could be a therapeutic option is relatively small (Pickard & Pearce ) and confined to those who repeatedly self‐harm.…”

Section: Discussionmentioning

confidence: 99%

‘There is no progression in prevention’ – The experiences of mental health nurses working with repeated self‐harm

Murphy

Keogh

Doyle

2019

Int J Mental Health Nurs

View full text Add to dashboard Cite

Caring for people who self‐harm is an everyday experience for mental health nurses and an important part of their role. How mental health nurses respond to and support those who self‐harm can have a significant impact on the outcomes for service users and their intentions to seek help in the future. Repeated self‐harm can be a particularly challenging phenomenon as it is often misunderstood and can have a negative impact on the therapeutic relationship. This qualitative descriptive study aims to explore how mental health nurses understand and work with repeated self‐harm. Nine nurses working in a range of mental health settings within one service participated in semi‐structured interviews which were analysed thematically. Findings are presented in two themes exploring participants’ perceptions and understanding of repeated self‐harm, and the process of learning to work with repeated self‐harm, and are reported in accordance with the consolidated criteria for reporting qualitative research guidelines (COREQ). Participants reported that nursing practice relating to repeated self‐harm remains largely focused on maintenance of safety and prevention of self‐harm despite the identification that this often does not work. It was accepted that there is sometimes a lack of understanding about the function of self‐harm; however, participants reported understanding increased following specific education about self‐harm. Participants also identified the potential for more empowering and recovery‐orientated responses, including the utilization of harm reduction approaches, to the care of those who repeatedly self‐harm.

show abstract

Section: Discussionmentioning

confidence: 99%

‘There is no progression in prevention’ – The experiences of mental health nurses working with repeated self‐harm

Murphy

Keogh

Doyle

2019

Int J Mental Health Nurs

View full text Add to dashboard Cite

show abstract

“…Such objections should not be taken lightly; however, one might also want to keep in mind that most interventions aimed at harm reduction have initially met with large scepticism [52]. (For further arguments for and against a harm reduction paradigm in self-injury, see also [53,54]. )…”

Section: Chronic Suicidality and Persistent Self-injury In Borderlinementioning

confidence: 99%

A palliative care approach in psychiatry: clinical implications

2020

View full text Add to dashboard Cite

Background: Traditionally, palliative care has focused on patients suffering from life-threatening somatic diseases such as cancer or progressive neurological disorders. In contrast, despite the often chronic, severely disabling, and potentially life-threatening nature of psychiatric disorders, there are neither palliative care units nor clinical guidelines on palliative measures for patients in psychiatry. Main text: This paper contributes to the growing literature on a palliative approach in psychiatry and is based on the assumption that a change of perspective from a curative to a palliative approach could help promote patientcenteredness and increase quality of life for severely ill patients in psychiatry as well as in somatic medicine. To exemplify this, we offer three different clinical scenarios: severe and enduring anorexia nervosa, treatment-refractory schizophrenia, and chronic suicidality and persistent self-injury in borderline personality disorder. Conclusion: We emphasize that many typical interventions for treatment-refractory psychiatric disorders may indeed be of a palliative nature. Furthermore, introducing traditional features of palliative care, e.g. so-called goals of care conversations, could aid even further in ensuring that caregivers, patients, and families agree on which treatment goals are to be prioritized in order to optimize quality of life in spite of severe, persistent mental disorder.

show abstract

Epistemic Injustice and Self-Injury: A Concept with Clinical Implications

Sullivan¹

2019

Philosophy, Psychiatry, & Psychology

View full text Add to dashboard Cite

Sometimes, not always, not never: a response to Pickard and Pearce

Cited by 3 publications

References 3 publications

‘There is no progression in prevention’ – The experiences of mental health nurses working with repeated self‐harm

‘There is no progression in prevention’ – The experiences of mental health nurses working with repeated self‐harm

A palliative care approach in psychiatry: clinical implications

Epistemic Injustice and Self-Injury: A Concept with Clinical Implications

Contact Info

Product

Resources

About