Harm minimisation for self-harm: a cross-sectional survey of British clinicians’ perspectives and practices
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 stu...
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| Format: | Article |
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BMJ Publishing Group
2022-06-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/6/e056199.full |
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| author | Alexandra Pitman Nicola Morant Faraz Mughal Sarah L Rowe Aishah Madinah Haris Evelina Bakanaite |
| author_facet | Alexandra Pitman Nicola Morant Faraz Mughal Sarah L Rowe Aishah Madinah Haris Evelina Bakanaite |
| author_sort | Alexandra Pitman |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-99f6dfab6b1a45e7aa1a113af21798ad |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2022-06-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-99f6dfab6b1a45e7aa1a113af21798ad2025-02-01T13:30:13ZengBMJ Publishing GroupBMJ Open2044-60552022-06-0112610.1136/bmjopen-2021-056199Harm minimisation for self-harm: a cross-sectional survey of British clinicians’ perspectives and practicesAlexandra Pitman0Nicola Morant1Faraz Mughal2Sarah L Rowe3Aishah Madinah Haris4Evelina Bakanaite5Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King’s College LondonDivision of Psychiatry, Faculty of Brain Sciences, University College London, London, UKSchool of Medicine, Keele University, Keele, UKDivision of Psychiatry, University College London, London, UKDivision of Psychiatry, University College London, London, UKDivision of Psychiatry, University College London, London, UKObjective 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.https://bmjopen.bmj.com/content/12/6/e056199.full |
| spellingShingle | Alexandra Pitman Nicola Morant Faraz Mughal Sarah L Rowe Aishah Madinah Haris Evelina Bakanaite Harm minimisation for self-harm: a cross-sectional survey of British clinicians’ perspectives and practices BMJ Open |
| title | Harm minimisation for self-harm: a cross-sectional survey of British clinicians’ perspectives and practices |
| title_full | Harm minimisation for self-harm: a cross-sectional survey of British clinicians’ perspectives and practices |
| title_fullStr | Harm minimisation for self-harm: a cross-sectional survey of British clinicians’ perspectives and practices |
| title_full_unstemmed | Harm minimisation for self-harm: a cross-sectional survey of British clinicians’ perspectives and practices |
| title_short | Harm minimisation for self-harm: a cross-sectional survey of British clinicians’ perspectives and practices |
| title_sort | harm minimisation for self harm a cross sectional survey of british clinicians perspectives and practices |
| url | https://bmjopen.bmj.com/content/12/6/e056199.full |
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