Working with Young People at Risk of Suicidal Behaviour and Self-Harm: A Qualitative Study of Australian General Practitioners’ Perspectives

Abstract

General Practitioners (GPs) play a crucial role in the identification and support of young people at risk of suicidal behaviour and self-harm; however, no studies have explored GPs’ perspectives, approaches, challenges, and resource needs when working with this cohort in an Australian setting. This was a qualitative study where fifteen GPs (Mage = 45.25 years) from multiple clinics in Western Australia took part in semi-structured interviews, and data were analysed thematically. Seven main themes were identified: (1) working with young people has its unique challenges; (2) screening and assessment tools can help to manage uncertainty and discomfort; (3) going beyond tools–the dialogue and relationship are most important; (4) there are limits to what we can offer in the time available; (5) the service access and referral pathways lack clarity and coordination; (6) the provision of mental health support should not fall on GPs alone; and (7) more comprehensive training in suicide and self-harm is needed. The findings highlight a number of opportunities to enhance care and better assist GPs working with young people who present with suicidal behaviour and self-harm, including considerations for conducting assessments, targeted resources such as training, and system and service improvements.

The functions of self‐harm in young people and their perspectives about future general practitioner‐led care: A qualitative study

“…Young people have previously suggested that self‐help materials from GPs would be helpful and this aligns to our findings, however concerns about time in the consultation were noted 36 . GPs have highlighted the importance of communication and relationship building with young people at risk of self‐harm and it's important to know that young people in this study felt future GP‐led treatments should enable the building of rapport which may help with feelings of social connectedness 37 . In an Australian focus group study of young people about care for suicidal behaviour/self‐harm in primary care, participants described wanting to be shown how to use tangible resources in the consultation with a GP, but not all participants had personal experience of self‐harm 24 .…”

“… 36 GPs have highlighted the importance of communication and relationship building with young people at risk of self‐harm and it's important to know that young people in this study felt future GP‐led treatments should enable the building of rapport which may help with feelings of social connectedness. 37 In an Australian focus group study of young people about care for suicidal behaviour/self‐harm in primary care, participants described wanting to be shown how to use tangible resources in the consultation with a GP, but not all participants had personal experience of self‐harm. 24 While practical resources are likely helpful for young people who have self‐harmed, GPs and family physicians should personalise them and offer distraction techniques to help the young person handle urges to self‐harm.…”

Biological Factors Underpinning Suicidal Behaviour: An Update

“…Approved therapeutics include several drugs administered to depressed patients to decrease the possibility of SI and SA, such as Lithium (mood-stabilizing drug), Clozapine (reduces suicidality, aggressive/impulsive behaviours), and Ketamine/Esketamine (antidepressant) [ 124 ]. An Australian study also showed the critical role of general practitioners in preventing suicide [ 125 ]. Drugs, social efforts, psychological awareness and guidance should be accompanied with a healthy lifestyle and integrated nutrition to resist SB ( Figure 4 ).…”