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Journal Article

Citation

Troya MI, Chew-Graham CA, Babatunde OO, Bartlam B, Mughal F, Dikomitis L. Br. J. Gen. Pract. 2019; ePub(ePub): ePub.

Affiliation

School of Primary, Community and Social Care, Keele University, Keele, UK; research director, School of Medicine, Keele University, Keele, UK.

Copyright

(Copyright © 2019, Royal College of General Practitioners)

DOI

10.3399/bjgp19X706049

PMID

31594769

Abstract

BACKGROUND: Self-harm and suicide are major public health concerns. Self-harm is the strongest risk factor for suicide, with the highest suicide rates reported in older populations. Little is known about how older adults access care following self-harm, but they are in frequent contact with primary care.

AIM: To identify and explore barriers and facilitators to accessing care within primary care for older adults who self-harm. DESIGN AND SETTING: An exploratory qualitative methods study using semi-structured interviews with older adults and third-sector workers in England. Older adults were invited to participate in one follow-up interview.

METHOD: Interviews occurred between September 2017 and September 2018. These were audio-recorded, transcribed verbatim, and data analysed thematically. A patient and public involvement and engagement group contributed to the study design, data analysis, and interpretation.

RESULTS: A total of 24 interviews with nine older adults and seven support workers, including eight follow-up interviews with older adults, were conducted. Three themes emerged: help-seeking decision factors; sources of support; and barriers and facilitators to accessing primary care.

CONCLUSION: Despite older adults' frequent contact with GPs, barriers to primary care existed, which included stigma, previous negative experiences, and practical barriers such as mobility restrictions. Older adults' help-seeking behaviour was facilitated by previous positive experiences. Primary care is a potential avenue for delivering effective self-harm support, management, and suicide prevention in older adults. Given the complex nature of self-harm, there is a need for primary care to work with other sectors to provide comprehensive support to older adults who self-harm.

© British Journal of General Practice 2019.


Language: en

Keywords

deliberate self-harm; frail older adults; primary care; qualitative research

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