[Psychiatric treatment of deliberate self-harm in the out-of-hours services]

(Psykiatrisk behandling av selvskading på legevakt.)

Full Abstract

BACKGROUND: Patients who harm themselves are often considered difficult to treat. There are no evidence-based approaches available for the emergency setting. General practitioners should nevertheless be able to offer interventions directed towards emotional needs in self-harm patients. In this article we suggest how to intervene in such situations. MATERIAL AND METHOD: Based on experience from Oslo psychiatric out-of-hours service and with elements from Dialectic Behavioural Therapy, we present a five-step model for treatment of these patients in an out-of-hours service within the primary health care services. RESULTS: The aim of this model is to bring the patient out of the acute crisis and to arrange for further treatment. Assessment, validation or confirmation, problem-solving, avoiding unnecessary hospitalisation, and focus on continuing established treatment, are important elements in the proposed intervention. This can all be carried out in 60 - 90 min. INTERPRETATION: The model may be suitable for training general practitioners to meet and care for patients with self-harm behaviour in the out-hours-services. We have positive experience with the intervention, but systematic research is necessary to assess the effect of the model.

Author information

Author/s: Walby, Fredrik A (FA); Ness, Ewa (E);

Affiliation: Psykiatrisk legevakt, Psykiatrisk divisjon, Oslo universitetssykehus, Ullevål.

Journal and publication information

Publication Type: English Abstract; Journal Article

Journal: Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række (Tidsskr Nor Laegeforen), published in Norway. (Language: nor)

Reference: 2009-Apr; vol 129 (issue 9) : pp 885-7

Dates: Created 2009/05/05; Completed 2009/05/18;

PMID: 19415091, status: MEDLINE (last retrieval date: 5/18/2009, IMS Date: 18 May 2009 00:00:00)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Family Practice
Humans
Mental Health Services
Norway
Problem Solving
Self-Injurious Behavior - diagnosis; psychology; therapy

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