General hospital staff often have negative attitudes towards people who self harm: new systematic review

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Researchers from Oxford University’s Centre for Suicide Research have conducted a systematic review of qualitative and quantitative studies that explore health service staff attitudes to people who self-harm.

It’s obvious to say that staff attitudes are going to have a big impact on the care of patients, but this research sought to review the nature of these attitudes, including the factors that influence self-harm behaviour, and the impact of training on attitudes, knowledge and behaviour of staff.

The researchers conducted a systematic search and limited their review to English language, which may well have excluded useful studies.  However, they found 74 studies to include in the review and they extracted data and gave each paper a quality rating.

Here’s what they found:

  • Attitudes of general hospital staff, especially doctors, were largely negative, particularly towards individuals who repeatedly self-harm
  • Self-harm patients were viewed more negatively than other patients, except those abusing alcohol or drugs
  • Psychiatric staff in community and hospital settings displayed more positive attitudes than general hospital staff
  • Negative attitudes were more common among doctors than nursing staff although this was only true of general hospital staff
  • Active training led to consistent improvements in attitude and knowledge in all groups.

The research team concluded:

Attitudes of general hospital staff towards self-harm patients are often negative, mirroring the experience of service users. Interventions can have a positive impact and improve the quality of patient care.

Saunders KE, Hawton K, Fortune S, Farrell S. Attitudes and knowledge of clinical staff regarding people who self-harm: A systematic review. J Affect Disord. 2011 Sep 16. [Epub ahead of print] [PubMed abstract]

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Andre Tomlin

Andre Tomlin

André Tomlin is an Information Scientist with 20 years experience working in evidence-based healthcare. He's worked in the NHS, for Oxford University and since 2002 as Managing Director of Minervation Ltd, a consultancy company who do clever digital stuff for charities, universities and the public sector. Most recently André has been the driving force behind the Mental Elf and the National Elf Service; an innovative digital platform that helps professionals keep up to date with simple, clear and engaging summaries of evidence-based research. André is a Trustee at the Centre for Mental Health and an Honorary Research Fellow at University College London Division of Psychiatry. He lives in Bristol with his wife, dog and three little elflings.

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