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Taking about self-harm: improving consultations between nurses and young people

A study of young people who self-harm revealed that a practice nurse conversation guide could help in consultations

A study of young people who self-harm revealed that a practice nurse conversation guide could help in consultations


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This participatory action research study explored why young people present with self-harm in primary care and how consultations could be more helpful. Twenty focus groups with young people, GPs and practice nurses were undertaken, plus analysis of 285 young people's medical records with self-harm coding (205 female, 80 male) from three general practices.

Of the 630 episodes of self-harm reported, only 465 recorded the type – 54% were with a sharp object, 25% overdoses, 14% thoughts of self-harm and 3% attempted suicide. Young women were significantly more likely to have recurrent episodes than young men.

Practice nurses reported they were more likely to see young people for another reason, such as contraception, and notice self-harm scars, but lacked the confidence to broach the subject. Young people reported that they were scared to talk about their self-harm and a number of reasons had led them to do it. 

Self-help interventions

The young people in the project sourced material to help in consultations including self-help materials and a practice nurse conversation guide which were shared with the practices. The GPs and practice nurses recognised the value of the resources but thought it would lead to lengthy consultations that were not currently possible. 

The study concluded that consideration needs to be given on how best to adopt self-help interventions for young people.


Vari Drennan is professor of healthcare and policy research at Kingston University and St George’s, University of London

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