Physicians can help mental health patients by adopting different questioning styles about suicide and self-harm

According to experts, doctors can better help patients with mental health concerns by adopting different question styles about self-harm and suicide.

A new study warns that patients may find it difficult to disclose their thoughts on self-harm because of the way GPs ask about them.

The scholars who considered the consultation tend to ask the GP questions that would lead to a “no” answer (for example, “Are you thinking of doing harm to yourself?”), And then the patient is self-harming. I found that I hesitated to report my thoughts on self-harm. -harm.

Research shows that self-harm discussions could be improved by the GP adopting a more open questioning style. This means accepting the possibility that the patient will say “yes” when asked about self-harm.

Researchers also say that doctors can better help patients with mental health concerns if they ask separate questions about self-harm and suicide. Physicians should encourage discussion if the response is ambiguous and perform a broader check to see if the patient has a distressing idea.

Scholars have studied video-recorded consultations from the One in a Million data archive. These consultations took place between 2014 and 2015. Researchers selected all consultations (18 in total) that featured discussions on self-harm and suicide, and conducted a detailed analysis of how these discussions evolved.

The study was conducted by Joseph Ford and Felicity Thomas at the University of Exeter, Richard Byng at the University of Plymouth, and Rose McCabe at City University of London and is published in the journal. Patient education and counseling.

Many patients who die of suicide have seen their GP in the month before their death. This shows how important these conversations are. However, previous research has shown that many GPs find these conversations difficult.They are worried about exacerbating the patient’s thoughts on suicide, or even keeping those thoughts in mind.. “

University of Exeter Joseph Ford

“The purpose of this study was to find out how these conversations actually evolved. By scrutinizing the actual recordings, we could identify ways to improve communication on these important topics. I was able to do it. “

Patients who admitted to self-harm during the consultation often hesitated to do so, disregarding the seriousness of the idea. This may mean leaving a long pause before providing a response or response, such as “have somehow” rather than a clear “yes”.

Professor McCabe said: “Conversations with professionals are very important because people who are experiencing self-harm or suicidal thoughts do not tend to share with friends and family. These pains to themselves and others. It’s hard to admit what you’re feeling. Thoughts and people feel a lot of shame and guilt. Therefore, questions that keep these thoughts further below the surface of the conversation are problematic. GPs and other professionals Should be aware of this and ask, for example, “sometimes people are thinking of hurting themselves.” Is this what you have experienced when they feel this way? Or “Some people think of ending their lives when they feel this way, is this what you have experienced?”

Patients also explained how to stay away from the negative stigmas associated with self-harm and not act on their own beliefs to influence their families.

This study suggests that GPs can alleviate such stigma by asking about the patient’s positive reasons for wanting to stay alive, rather than the negative effects of suicide on those around them.

The study also found that GPs overwhelmingly focused on the likelihood that patients would act on their own beliefs. This allowed us to take appropriate action, but at risk of ignoring patients who were suffering from self-harm. It also potentially avoids finding out what some patients are willing to do to cope with their situation.

Professor Bin said: “Supporting practitioners to shift conversations to more therapeutic listening modes, or even help individuals see hope through results, while understanding the pain felt by patients and the anxiety felt by doctors in these encounters. I suggest what you can do. Of their own positive future actions. “