Best practice when working with suicidal behaviour and self-harm in primary care: a qualitative exploration of young people's perspectives

Research output: Contribution to journalArticlepeer-review


  • India Bellairs-Walsh
  • Yael Perry
  • Karolina Krysinska
  • Sadhbh J Byrne
  • Alexandra Boland
  • Michelle Lamblin
  • Kerry L Gibson
  • Ashleigh Lin
  • Tina Yutong Li
  • Sarah Hetrick
  • Jo Robinson

Colleges, School and Institutes

External organisations

  • Orygen
  • Trauma and General Surgeon Royal Perth Hospital & The University of Western Australia, Perth, Australia.
  • University of Auckland


OBJECTIVES: General practitioners (GPs) have a key role in supporting young people who present with suicidal behaviour/self-harm. However, little is known about young people's opinions and experiences related to GPs' practices for such presentations, and their decisions to disclose suicidal behaviour/self-harm to GPs. Additionally, existing guidelines for the management of suicide risk and/or self-harm have not incorporated young people's perspectives. This study aimed to explore young people's views and experiences related to the identification, assessment and care of suicidal behaviour and self-harm in primary care settings with GPs.

DESIGN, SETTING AND PARTICIPANTS: Two qualitative focus groups were conducted in Perth, Western Australia, with 10 young people in total (Mage = 20.67 years; range: 16-24). Data were collected using a semistructured, open-ended interview schedule and analysed using thematic analysis.

RESULTS: Five major themes were identified from the focus groups. (1) Young people wanted a collaborative dialogue with GPs, which included being asked about suicidal behaviour/self-harm, informed of treatment processes and having autonomy in decision making; (2) young people were concerned with a loss of privacy when disclosing suicidal behaviour/self-harm; (3) young people viewed labels and assessments as problematic and reductionist-disliking the terms 'risk' and 'risk assessment', and assessment approaches that are binary and non-holistic; (4) young people highlighted the importance of GPs' attitudes, with a genuine connection, attentiveness and a non-judgemental demeanour seen as paramount; and (5) young people wanted to be provided with practical support and resources, followed-up, and for GPs to be competent when working with suicidal behaviour/self-harm presentations.

CONCLUSIONS: Our study identified several concerns and recommendations young people have regarding the identification, assessment and care of suicidal behaviour/self-harm in primary care settings. Taken together, these findings may inform the development of resources for GPs, and support progress in youth-oriented best practice.

Bibliographic note

© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.


Original languageEnglish
Pages (from-to)e038855
JournalBMJ open
Issue number10
Publication statusPublished - 28 Oct 2020


  • Adolescent, Adult, Age Factors, Humans, Primary Health Care, Psychology, Adolescent, Qualitative Research, Self-Injurious Behavior/therapy, Suicidal Ideation, Western Australia, Young Adult

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