Orygen, Parkville, Victoria, Australia
Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia.
BMJ Open. 2020 Oct 28;10(10):e038855. doi: 10.1136/bmjopen-2020-038855.
General practitioners (GPs) have a key role in supporting young people who present with suicidal behaviour/self-harm. However, little is known about young people's opinions and experiences related to GPs' practices for such presentations, and their decisions to disclose suicidal behaviour/self-harm to GPs. Additionally, existing guidelines for the management of suicide risk and/or self-harm have not incorporated young people's perspectives. This study aimed to explore young people's views and experiences related to the identification, assessment and care of suicidal behaviour and self-harm in primary care settings with GPs.
DESIGN, SETTING AND PARTICIPANTS: Two qualitative focus groups were conducted in Perth, Western Australia, with 10 young people in total ( = 20.67 years; range: 16-24). Data were collected using a semistructured, open-ended interview schedule and analysed using thematic analysis.
Five major themes were identified from the focus groups. (1) Young people wanted a collaborative dialogue with GPs, which included being asked about suicidal behaviour/self-harm, informed of treatment processes and having autonomy in decision making; (2) young people were concerned with a loss of privacy when disclosing suicidal behaviour/self-harm; (3) young people viewed labels and assessments as problematic and reductionist-disliking the terms 'risk' and 'risk assessment', and assessment approaches that are binary and non-holistic; (4) young people highlighted the importance of GPs' attitudes, with a genuine connection, attentiveness and a non-judgemental demeanour seen as paramount; and (5) young people wanted to be provided with practical support and resources, followed-up, and for GPs to be competent when working with suicidal behaviour/self-harm presentations.
Our study identified several concerns and recommendations young people have regarding the identification, assessment and care of suicidal behaviour/self-harm in primary care settings. Taken together, these findings may inform the development of resources for GPs, and support progress in youth-oriented best practice.
全科医生（GP）在支持出现自杀行为/自伤的年轻人方面发挥着关键作用。然而，人们对年轻人对 GP 处理此类就诊的实践以及他们向 GP 透露自杀行为/自伤的决定的意见和经验知之甚少。此外，现有的自杀风险和/或自伤管理指南并未纳入年轻人的观点。本研究旨在探讨年轻人对初级保健环境中识别、评估和护理自杀行为和自伤的看法和经验。
设计、地点和参与者：在西澳大利亚州珀斯进行了两次定性焦点小组讨论，共有 10 名年轻人参加（= 20.67 岁；范围：16-24 岁）。使用半结构化的开放式访谈大纲收集数据，并使用主题分析进行分析。
从焦点小组中确定了五个主要主题。（1）年轻人希望与 GP 进行协作对话，包括询问自杀行为/自伤、告知治疗过程并在决策中拥有自主权；（2）年轻人担心披露自杀行为/自伤时会失去隐私；（3）年轻人认为标签和评估有问题，简化论——不喜欢“风险”和“风险评估”这两个术语，以及二元和非整体的评估方法；（4）年轻人强调 GP 态度的重要性，真正的联系、关注和非评判的态度被视为至关重要；（5）年轻人希望获得实际的支持和资源，得到跟进，并希望 GP 在处理自杀行为/自伤就诊时具有能力。
我们的研究确定了年轻人对初级保健环境中识别、评估和护理自杀行为/自伤的一些关注和建议。这些发现可以为 GP 提供资源，并支持以年轻人为导向的最佳实践的进展。
