News Release

Guidelines do not prevent deliberate self harm

General practice based intervention to prevent repeat episodes of deliberate self harm: cluster randomised controlled trial, BMJ Volume 324, pp 1254-7

Peer-Reviewed Publication

BMJ

Clinical guidelines do not reduce the rate of repeated self harm, and more research is needed on how to manage patients who deliberately harm themselves, suggest researchers from Bristol University in this week’s BMJ.

The study involved 1,932 patients, registered with 98 general practices, who had attended accident and emergency departments at one of four general hospitals after an episode of deliberate self harm.

The practices were assigned in equal numbers to an intervention or a control group. The intervention comprised a letter from the general practitioner inviting the patient to consult, and guidelines on assessment and management of deliberate self harm for the general practitioner to use in consultations. Control patients received usual general practitioner care.

After 12 months, the level of repeat episodes of deliberate self harm was no different for patients in the intervention group compared with the control group. This lack of benefit leaves open the question of the most effective management in general practice of patients who deliberately harm themselves, say the authors.

The high proportion of patients who make contact with general practitioners after an episode of deliberate self harm suggests that more research is needed on how best to manage such patients in primary care to reduce the incidence of repeated episodes, they conclude.

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