Liaison psychiatry practitioners’ views on accessing aftercare and psychological therapies for patients who present to hospital following self-harm: multi-site interview study
Background Timely provision of aftercare following self-harm may reduce risks of repetition and premature death, but existing services are frequently reported as being inadequate. Aims To explore barriers and facilitators to accessing aftercare and psychological therapies for patients presenting to...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2023-03-01
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| Series: | BJPsych Open |
| Subjects: | |
| Online Access: | https://www.cambridge.org/core/product/identifier/S2056472423000029/type/journal_article |
| _version_ | 1811156849331798016 |
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| author | Leah Quinlivan Louise Gorman Stephen Marks Elizabeth Monaghan Sadika Asmal Roger T. Webb Nav Kapur |
| author_facet | Leah Quinlivan Louise Gorman Stephen Marks Elizabeth Monaghan Sadika Asmal Roger T. Webb Nav Kapur |
| author_sort | Leah Quinlivan |
| collection | DOAJ |
| description | Background
Timely provision of aftercare following self-harm may reduce risks of repetition and premature death, but existing services are frequently reported as being inadequate.
Aims
To explore barriers and facilitators to accessing aftercare and psychological therapies for patients presenting to hospital following self-harm, from the perspective of liaison psychiatry practitioners.
Method
Between March 2019 and December 2020, we interviewed 51 staff members across 32 liaison psychiatry services in England. We used thematic analyses to interpret the interview data.
Results
Barriers to accessing services may heighten risk of further self-harm for patients and burnout for staff. Barriers included: perceived risk, exclusionary thresholds, long waiting times, siloed working and bureaucracy. Strategies to increase access to aftercare included: (a) improving assessments and care plans via input from skilled staff working in multidisciplinary teams (e.g. including social workers and clinical psychologists); (b) supporting staff to focus on assessments as therapeutic intervention; (c) probing boundaries and involving senior staff to negotiate risk and advocate for patients; and (d) building relationships and integration across services.
Conclusions
Our findings highlight practitioners’ views on barriers to accessing aftercare and strategies to circumvent some of these impediments. Provision of aftercare and psychological therapies as part of the liaison psychiatry service were deemed as an essential mechanism for optimising patient safety and experience and staff well-being. To close treatment gaps and reduce inequalities, it is important to work closely with staff and patients, learn from experiences of good practice and implement change more widely across services.
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| first_indexed | 2024-04-10T04:57:59Z |
| format | Article |
| id | doaj.art-5bb1aea893fd4b36bd49de9dd41b823e |
| institution | Directory Open Access Journal |
| issn | 2056-4724 |
| language | English |
| last_indexed | 2024-04-10T04:57:59Z |
| publishDate | 2023-03-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | BJPsych Open |
| spelling | doaj.art-5bb1aea893fd4b36bd49de9dd41b823e2023-03-09T12:29:29ZengCambridge University PressBJPsych Open2056-47242023-03-01910.1192/bjo.2023.2Liaison psychiatry practitioners’ views on accessing aftercare and psychological therapies for patients who present to hospital following self-harm: multi-site interview studyLeah Quinlivan0https://orcid.org/0000-0002-3944-3613Louise Gorman1https://orcid.org/0000-0002-6570-7272Stephen Marks2Elizabeth Monaghan3Sadika Asmal4Roger T. Webb5Nav Kapur6https://orcid.org/0000-0002-3100-3234Centre for Mental Health and Safety, University of Manchester, UK; Manchester Academic Health Science Centre, University of Manchester, UK; and National Institute for Health and Care Research (NIHR) Greater Manchester Patient Safety Translational Research Centre, University of Manchester, UKCentre for Mental Health and Safety, University of Manchester, UK; Manchester Academic Health Science Centre, University of Manchester, UK; and National Institute for Health and Care Research (NIHR) Greater Manchester Patient Safety Translational Research Centre, University of Manchester, UKDepartment of Nursing, Faculty of Health and Education, Manchester Metropolitan University, UKNational Institute for Health and Care Research (NIHR) Greater Manchester Patient Safety Translational Research Centre, University of Manchester, UKNational Institute for Health and Care Research (NIHR) Greater Manchester Patient Safety Translational Research Centre, University of Manchester, UKCentre for Mental Health and Safety, University of Manchester, UK; Manchester Academic Health Science Centre, University of Manchester, UK; and National Institute for Health and Care Research (NIHR) Greater Manchester Patient Safety Translational Research Centre, University of Manchester, UKCentre for Mental Health and Safety, University of Manchester, UK; Manchester Academic Health Science Centre, University of Manchester, UK; National Institute for Health and Care Research (NIHR) Greater Manchester Patient Safety Translational Research Centre, University of Manchester, UK; and Greater Manchester Mental Health NHS Foundation Trust, Manchester, UKBackground Timely provision of aftercare following self-harm may reduce risks of repetition and premature death, but existing services are frequently reported as being inadequate. Aims To explore barriers and facilitators to accessing aftercare and psychological therapies for patients presenting to hospital following self-harm, from the perspective of liaison psychiatry practitioners. Method Between March 2019 and December 2020, we interviewed 51 staff members across 32 liaison psychiatry services in England. We used thematic analyses to interpret the interview data. Results Barriers to accessing services may heighten risk of further self-harm for patients and burnout for staff. Barriers included: perceived risk, exclusionary thresholds, long waiting times, siloed working and bureaucracy. Strategies to increase access to aftercare included: (a) improving assessments and care plans via input from skilled staff working in multidisciplinary teams (e.g. including social workers and clinical psychologists); (b) supporting staff to focus on assessments as therapeutic intervention; (c) probing boundaries and involving senior staff to negotiate risk and advocate for patients; and (d) building relationships and integration across services. Conclusions Our findings highlight practitioners’ views on barriers to accessing aftercare and strategies to circumvent some of these impediments. Provision of aftercare and psychological therapies as part of the liaison psychiatry service were deemed as an essential mechanism for optimising patient safety and experience and staff well-being. To close treatment gaps and reduce inequalities, it is important to work closely with staff and patients, learn from experiences of good practice and implement change more widely across services. https://www.cambridge.org/core/product/identifier/S2056472423000029/type/journal_articleSelf-harmhealth servicesliaison psychiatrystaff viewspsychological therapies |
| spellingShingle | Leah Quinlivan Louise Gorman Stephen Marks Elizabeth Monaghan Sadika Asmal Roger T. Webb Nav Kapur Liaison psychiatry practitioners’ views on accessing aftercare and psychological therapies for patients who present to hospital following self-harm: multi-site interview study BJPsych Open Self-harm health services liaison psychiatry staff views psychological therapies |
| title | Liaison psychiatry practitioners’ views on accessing aftercare and psychological therapies for patients who present to hospital following self-harm: multi-site interview study |
| title_full | Liaison psychiatry practitioners’ views on accessing aftercare and psychological therapies for patients who present to hospital following self-harm: multi-site interview study |
| title_fullStr | Liaison psychiatry practitioners’ views on accessing aftercare and psychological therapies for patients who present to hospital following self-harm: multi-site interview study |
| title_full_unstemmed | Liaison psychiatry practitioners’ views on accessing aftercare and psychological therapies for patients who present to hospital following self-harm: multi-site interview study |
| title_short | Liaison psychiatry practitioners’ views on accessing aftercare and psychological therapies for patients who present to hospital following self-harm: multi-site interview study |
| title_sort | liaison psychiatry practitioners views on accessing aftercare and psychological therapies for patients who present to hospital following self harm multi site interview study |
| topic | Self-harm health services liaison psychiatry staff views psychological therapies |
| url | https://www.cambridge.org/core/product/identifier/S2056472423000029/type/journal_article |
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