Can mainstream health services provide meaningful care for people who self-harm? A critical reflection.
People who self-harm currently access health care based in a wide variety of settings. These include primary care, accident and emergency departments, and specialist mental health providers. This paper considers whether meaningful care for people who self-harm can be provided within these mainstream health services. The paper begins by clarifying the meaning of self-harm and distinguishes self-harm from suicide. Four treatment models applied in clinical practice are identified: (i) psychodynamic, (ii) behavioural, (iii) biosocial and (iv) feminist. Each of these is critically considered in terms of practical utility, professional attitudes and wider organizational/policy context.
Simpson
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Department of Health Sciences, University of York, York, UK. aes4@york.ac.uk
D001291:Attitude of Health Personnel; D004637:Emergency Services, Psychiatric / Q000458:organization & administration; D004645:Empathy; D019513:Feminism; D006297:Health Services Accessibility / Q000458:organization & administration; D006801:Humans; D008605:Mental Health Services / Q000458:organization & administration*; D017146:Models, Organizational; D020380:Needs Assessment / Q000458:organization & administration*; D009341:Negativism; D010686:Philosophy, Medical; D017410:Practice Guidelines as Topic; D011287:Prejudice; D011320:Primary Health Care / Q000458:organization & administration; D016730:Program Development; D011568:Psychiatric Nursing / Q000458:organization & administration; D011570:Psychiatry / Q000458:organization & administration; D011582:Psychological Theory; D011787:Quality of Health Care / Q000458:organization & administration*; D012649:Self Concept; D016728:Self-Injurious Behavior / Q000175:diagnosis / Q000209:etiology / Q000523:psychology / Q000628:therapy*