Haris, Aishah Madinah;
Pitman, Alexandra;
Mughal, Faraz;
Bakanaite, Evelina;
Morant, Nicola;
Rowe, Sarah L;
(2022)
Harm minimisation for self-harm: a cross-sectional survey of British clinicians’ perspectives and practises.
BMJ Open
, 12
(6)
, Article e056199. 10.1136/bmjopen-2021-056199.
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Abstract
OBJECTIVE: Harm minimisation for self-harm is an alternative to preventive strategies and focuses on maximising safety when self-harming. We explored the views of clinicians on harm minimisation for self-harm to describe reported use and acceptability in clinical practice. DESIGN: A cross-sectional study using an online survey consisting of fixed-choice and open-ended questions. SETTING: Primary and secondary care practices in England, Scotland and Wales. PARTICIPANTS: Snowball sampling of UK-based clinicians (n=90; 67% female) working with people who self-harm and who have or have not previously recommended harm minimisation methods to patients. RESULTS: Of the 90 clinicians sampled, 76 (84%) reported having recommended harm minimisation techniques to people in their care who self-harm. Commonly recommended techniques were snapping rubber bands on one’s wrist and squeezing ice. Other techniques, such as teaching use of clean instruments when self-harming, were less likely to be recommended. Perceived client benefits included harm reduction and promotion of the therapeutic relationship. Perceived potential limitations of a harm minimisation approach for self-harm were (a) potential worsening of self-harm outcomes; (b) ethical reservations; (c) doubts about its effectiveness and appropriateness; and (d) lack of training and clear policies within the workplace. CONCLUSIONS: In our sample of UK-based clinicians in various settings, harm minimisation for self-harm was broadly recommended for clients who self-harm due to perceived client benefits. However, future policies on harm minimisation must address clinicians’ perceived needs for training, well-defined guidelines, and clear evidence of effectiveness and safety to mitigate some clinician concerns about the potential for further harm.
| Type: | Article |
|---|---|
| Title: | Harm minimisation for self-harm: a cross-sectional survey of British clinicians’ perspectives and practises |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1136/bmjopen-2021-056199 |
| Publisher version: | http://dx.doi.org/10.1136/bmjopen-2021-056199 |
| Language: | English |
| Additional information: | © 2022 BMJ Publishing Group Ltd. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license (http://creativecommons.org/licenses/by-nc/4.0/). |
| UCL classification: | UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10150300 |
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