Caring for self-harming patients in general practice
Joanne Rowe 1 , Chrystal Jaye 11 University of Otago, Department of General Practice and Rural Health, Dunedin, New Zealand
Correspondence to: Chrystal Jaye, Department of General Practice and Rural Health, University of Otago, PO Box 56, Dunedin 9054, New Zealand. Email: chrystal.jaye@otago.ac.nz
Journal of Primary Health Care 9(4) 279-285 https://doi.org/10.1071/HC17023
Published: 13 October 2017
Journal Compilation © Royal New Zealand College of General Practitioners 2017.
This is an open access article licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Abstract
INTRODUCTION: Intentional self-harm is an international public health issue with high personal, social and financial costs to society. Poor relationship dynamics are known to have a negative influence on the psyche of people who self-harm, and this can increase anxiety and decrease self-esteem, both shown to be significant contributors to self-harm behaviours. Positive and functional social supports have been proposed as a cost-effective and constructive approach in diminishing self-harming behaviours.
AIM: This qualitative study investigated the aspects of professional, social, familial and romantic relationships that people who have self-harmed identified as having a positive and constructive effect on their self-harm behaviour.
METHODS: Twelve participants with a history of self-harming behaviours were recruited through free press advertising in primary care and interviewed. The participants ranged in age from 19 to 70 years, and represented New Zealand (NZ) European and Māori from across the Southern region of NZ.
RESULTS: This study shows that constructive relationships that inhibit self-harm behaviours are characterised by participants’ perceptions of authenticity in their relationships, and knowing that other people genuinely care. Feeling cared for within an authentic therapeutic relationship enabled participants to overcome their perception of being damaged selves and gave them the skills and confidence to develop functional relationships within their communities. A relationship-centred care approach may be useful for general practitioners seeking to develop more effective therapeutic relationships with patients who deliberately self-harm.
KEYWORDS: Doctor–patient relationships; primary health care; mental health
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