title: Predictors of A&E staff attitudes to self-harm patients who use self-laceration: influence of previous training and experience.
abstract: OBJECTIVE
  The aim of this study was to investigate the attitudes of accident and emergency (A&E) staff towards patients who self-harm through laceration.
  
  
  METHODS
  We developed a questionnaire using focus group methodology. Questionnaires were distributed to 117 A&E staff members.
  
  
  RESULTS
  Of the staff, 53.8% responded. The staff believed that self-laceration was an important problem but felt unskilled in managing patients. The staff were unsure of the relationship between self-laceration and both mental illness and risk of suicide. They had previously received little training in managing this condition. In those staff without previous training, a longer period working in A&E was correlated with higher levels of anger towards patients and an inclination not to view patients as mentally ill. A&E staff were keen for further training and wanted a higher proportion of patients to be seen by specialist mental health services.
  
  
  CONCLUSIONS
  This study highlights the need for greater staff training in A&E. Despite considerable experience in the field, we found evidence for unhelpful attitudes amongst some staff. This is particularly true for more senior staff without previous DSH training, who, as a group, were less sympathetic to this group of patients. Unfavourable attitudes of health professionals are likely to adversely influence the quality of clinical care delivered to DSH patients who use self-laceration as well as those who use other methods of self-harm.
authors.affiliation: Department of Liaison Psychiatry, Brandon Unit, Leicester General Hospital, Leicester LE5 4PW, United Kingdom. trevor.friedman@leicspart.nhs.uk
authors.forename: Trevor
authors.initials: T
authors.lastname: Friedman
authors.forename: Charles
authors.initials: C
authors.lastname: Newton
authors.forename: Christine
authors.initials: C
authors.lastname: Coggan
authors.forename: Samantha
authors.initials: S
authors.lastname: Hooley
authors.forename: Rekha
authors.initials: R
authors.lastname: Patel
authors.forename: Matthew
authors.initials: M
authors.lastname: Pickard
authors.forename: Alex J
authors.initials: AJ
authors.lastname: Mitchell
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D005260:Female; D006801:Humans; D008297:Male; D011361:Professional Competence; D016728:Self-Injurious Behavior / Q000453:epidemiology*; D011795:Surveys and Questionnaires