{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T22:23:19Z","timestamp":1762899799503},"reference-count":35,"publisher":"Royal College of General Practitioners","issue":"688","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Gen Pract"],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Self-harm and suicide are major public health concerns. Self-harm is the strongest risk factor for suicide, with the highest suicide rates reported in older populations. Little is known about how older adults access care following self-harm, but they are in frequent contact with primary care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To identify and explore barriers and facilitators to accessing care within primary care for older adults who self-harm.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design and setting<\/jats:title><jats:p>An exploratory qualitative methods study using semi-structured interviews with older adults and third-sector workers in England. Older adults were invited to participate in one follow-up interview.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Interviews occurred between September 2017 and September 2018. These were audio-recorded, transcribed verbatim, and data analysed thematically. A patient and public involvement and engagement group contributed to the study design, data analysis, and interpretation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 24 interviews with nine older adults and seven support workers, including eight follow-up interviews with older adults, were conducted. Three themes emerged: help-seeking decision factors; sources of support; and barriers and facilitators to accessing primary care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Despite older adults\u2019 frequent contact with GPs, barriers to primary care existed, which included stigma, previous negative experiences, and practical barriers such as mobility restrictions. Older adults\u2019 help-seeking behaviour was facilitated by previous positive experiences. Primary care is a potential avenue for delivering effective self-harm support, management, and suicide prevention in older adults. Given the complex nature of self-harm, there is a need for primary care to work with other sectors to provide comprehensive support to older adults who self-harm.<\/jats:p><\/jats:sec>","DOI":"10.3399\/bjgp19x706049","type":"journal-article","created":{"date-parts":[[2019,10,8]],"date-time":"2019-10-08T12:35:12Z","timestamp":1570538112000},"page":"e740-e751","source":"Crossref","is-referenced-by-count":15,"title":["Role of primary care in supporting older adults who self-harm: a qualitative study in England"],"prefix":"10.3399","volume":"69","author":[{"given":"M Isabela","family":"Troya","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carolyn A","family":"Chew-Graham","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Opeyemi","family":"Babatunde","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernadette","family":"Bartlam","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Faraz","family":"Mughal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa","family":"Dikomitis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1987","published-online":{"date-parts":[[2019,10,8]]},"reference":[{"key":"2020081209341340000_69.688.e740.1","unstructured":"National Institute for Health and Care Excellence (2011) Self-harm in over 8s: long-term management CG133 (NICE, London) https:\/\/www.nice.org.uk\/guidance\/cg133 (accessed 20 Sep 2019)."},{"key":"2020081209341340000_69.688.e740.2","unstructured":"Department of Health and Social Care. (2017) Preventing suicide in England: third progress report on the cross-government outcomes strategy to save lives, https:\/\/www.gov.uk\/government\/publications\/suicide-prevention-third-annual-report (accessed 20 Sep 2019)."},{"issue":"11","key":"2020081209341340000_69.688.e740.3","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1016\/S2215-0366(18)30348-1","article-title":"Self-harm in a primary care cohort of older people: incidence, clinical management, and risk of suicide and other causes of death","volume":"5","author":"Morgan","year":"2018","journal-title":"Lancet Psychiatry"},{"issue":"4","key":"2020081209341340000_69.688.e740.4","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1192\/bjp.2019.11","article-title":"Self-harm in older adults: systematic review","volume":"214","author":"Troya","year":"2019","journal-title":"Br J Psychiatry"},{"key":"2020081209341340000_69.688.e740.5","first-page":"w13648","article-title":"Cost of attempted suicide: a retrospective study of extent and associated factors","volume":"142","author":"Czernin","year":"2012","journal-title":"Swiss Med Wkly"},{"key":"2020081209341340000_69.688.e740.6","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1016\/j.eclinm.2019.06.002","article-title":"Understanding self-harm in older adults: a qualitative study","volume":"12","author":"Troya","year":"2019","journal-title":"EClinicalMedicine"},{"key":"2020081209341340000_69.688.e740.7","unstructured":"McManus S Lubian K Bennett C (2019) Suicide and self-harm in Britain \u2014 researching risk and resilience using UK surveys, http:\/\/www.natcen.ac.uk\/media\/1704167\/Suicide-and-self-harm-in-Britain-Main-report.pdf (accessed 20 Sep 2019)."},{"issue":"3","key":"2020081209341340000_69.688.e740.8","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1111\/hsc.12420","article-title":"Care co-ordination for older people in the third sector: scoping the evidence","volume":"26","author":"Abendstern","year":"2018","journal-title":"Health Soc Care Community"},{"key":"2020081209341340000_69.688.e740.9","unstructured":"Green J Thorogood N (2018) Qualitative methods for health research (Sage Publications, London), 4th edn."},{"key":"2020081209341340000_69.688.e740.10","doi-asserted-by":"crossref","unstructured":"Mason J (2002) Researching your own practice: the discipline of noticing (Routledge, Abingdon).","DOI":"10.4324\/9780203471876"},{"key":"2020081209341340000_69.688.e740.11","unstructured":"Salda\u00f1a J (2003) Longitudinal qualitative research: analyzing change through time (AltaMira Press, Lanham, MD)."},{"key":"2020081209341340000_69.688.e740.12","doi-asserted-by":"publisher","DOI":"10.1191\/1478088706qp063oa"},{"key":"2020081209341340000_69.688.e740.13","doi-asserted-by":"crossref","unstructured":"Glaser BG Strauss AL (2017) Discovery of grounded theory: strategies for qualitative research (Routledge, Abingdon).","DOI":"10.4324\/9780203793206"},{"issue":"4","key":"2020081209341340000_69.688.e740.14","doi-asserted-by":"crossref","first-page":"1893","DOI":"10.1007\/s11135-017-0574-8","article-title":"Saturation in qualitative research: exploring its conceptualization and operationalization","volume":"52","author":"Saunders","year":"2018","journal-title":"Qual Quant"},{"key":"2020081209341340000_69.688.e740.15","doi-asserted-by":"publisher","DOI":"10.1111\/j.1475-6773.2006.00684.x"},{"key":"2020081209341340000_69.688.e740.16","doi-asserted-by":"publisher","DOI":"10.1177\/1558689812437186"},{"issue":"4","key":"2020081209341340000_69.688.e740.17","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1111\/hex.12917","article-title":"Patient and Public Involvement and Engagement in a doctoral research project exploring self-harm in older adults","volume":"22","author":"Troya","year":"2019","journal-title":"Health Expect"},{"issue":"516","key":"2020081209341340000_69.688.e740.18","first-page":"503","article-title":"A qualitative study of help seeking and primary care consultation prior to suicide","volume":"55","author":"Owens","year":"2005","journal-title":"Br J Gen Pract"},{"issue":"1","key":"2020081209341340000_69.688.e740.19","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1027\/0227-5910\/a000325","article-title":"General practitioners\u2019 accounts of patients who have self-harmed","volume":"37","author":"Chandler","year":"2016","journal-title":"Crisis"},{"key":"2020081209341340000_69.688.e740.20","doi-asserted-by":"publisher","DOI":"10.1093\/fampra\/cmv031"},{"key":"2020081209341340000_69.688.e740.21","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1186\/1472-6963-14-208","article-title":"Perceived competence and attitudes towards patients with suicidal behaviour: a survey of general practitioners, psychiatrists and internists","volume":"14","author":"Grimholt","year":"2014","journal-title":"BMC Health Serv Res"},{"key":"2020081209341340000_69.688.e740.22","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2015-009654"},{"key":"2020081209341340000_69.688.e740.23","doi-asserted-by":"publisher","DOI":"10.1111\/sltb.12001"},{"issue":"3","key":"2020081209341340000_69.688.e740.24","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1111\/hsc.12198","article-title":"General practitioners\u2019 perspectives on primary care consultations for suicidal patients","volume":"24","author":"Saini","year":"2016","journal-title":"Health Soc Care Community"},{"issue":"3","key":"2020081209341340000_69.688.e740.25","doi-asserted-by":"crossref","first-page":"146","DOI":"10.31128\/AFP-08-17-4311","article-title":"How do general practitioners conceptualise self-harm in their older patients? A qualitative study","volume":"47","author":"Wand","year":"2018","journal-title":"Aust J Gen Pract"},{"key":"2020081209341340000_69.688.e740.26","unstructured":"National Institute for Health and Care Excellence (2018) Preventing suicide in community and custodial settings NG105 (NICE, London) https:\/\/www.nice.org.uk\/guidance\/ng105 (accessed 20 Sep 2019)."},{"key":"2020081209341340000_69.688.e740.27","doi-asserted-by":"publisher","DOI":"10.1186\/1471-244X-10-113"},{"key":"2020081209341340000_69.688.e740.28","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.107.046425"},{"key":"2020081209341340000_69.688.e740.29","doi-asserted-by":"publisher","DOI":"10.1017\/S0144686X99007710"},{"issue":"11","key":"2020081209341340000_69.688.e740.30","doi-asserted-by":"crossref","first-page":"1456","DOI":"10.1080\/13607863.2017.1364347","article-title":"Experiences of ageism and the mental health of older adults","volume":"22","author":"Lyons","year":"2017","journal-title":"Aging Ment Health"},{"key":"2020081209341340000_69.688.e740.31","doi-asserted-by":"publisher","DOI":"10.1093\/geronb\/gbv079"},{"key":"2020081209341340000_69.688.e740.32","doi-asserted-by":"publisher","DOI":"10.1016\/S0277-9536(98)00222-6"},{"issue":"2","key":"2020081209341340000_69.688.e740.33","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/0160-7979(80)90026-0","article-title":"Patient attitudes toward health care: expectations of primary care in a clinic setting","volume":"14A","author":"Greene","year":"1980","journal-title":"Soc Sci Med Med Psychol Med Sociol"},{"key":"2020081209341340000_69.688.e740.34","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-6-35"},{"key":"2020081209341340000_69.688.e740.35","doi-asserted-by":"crossref","unstructured":"Bodner E Palgi Y Wyman MF (2018) in Contemporary perspectives on ageism, Ageism in mental health assessment and treatment of older adults, eds Ayalon L Tesch-R\u00f6mer C (Springer, New York, NY).","DOI":"10.1007\/978-3-319-73820-8_15"}],"container-title":["British Journal of General Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.3399\/bjgp19X706049","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,2,25]],"date-time":"2022-02-25T19:53:27Z","timestamp":1645818807000},"score":1,"resource":{"primary":{"URL":"https:\/\/bjgp.org\/lookup\/doi\/10.3399\/bjgp19X706049"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,10,8]]},"references-count":35,"journal-issue":{"issue":"688","published-online":{"date-parts":[[2019,10,31]]},"published-print":{"date-parts":[[2019,11]]}},"alternative-id":["10.3399\/bjgp19X706049"],"URL":"https:\/\/doi.org\/10.3399\/bjgp19x706049","relation":{},"ISSN":["0960-1643","1478-5242"],"issn-type":[{"value":"0960-1643","type":"print"},{"value":"1478-5242","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,10,8]]}}}