Intended for healthcare professionals


General practice based interventions to prevent repeat episodes of deliberate self harm

BMJ 2002; 325 doi: (Published 03 August 2002) Cite this as: BMJ 2002;325:281

GPs have to manage this problem

  1. Alex J Mitchell (, lecturer in psychiatry
  1. University of Leeds, Leeds LS2 9LN
  2. Academic Unit of Psychiatry and Behavioural Sciences, School of Medicine, University of Leeds, Leeds LS2 9LT

    EDITOR—The disappointing results of Bennewith et al's study are not particularly surprising.1 The intervention that they used (an offer of contact and an educational handout) was not beneficial in 11 previous studies.2 Indeed, no intervention has been effective in reducing future deliberate self harm, even when conducted by motivated researchers. This is probably because of the difficulty in overcoming the unpredictable future adverse circumstances of people who harm themselves.

    Embedded Image

    (Credit: P MARAZZI/SPL)

    General practitioners require a much more powerful tool than a handout to manage this complex group of patients. There is also an important methodological problem with the study concerning the population under study, as the authors have captured not only those who have made many attempts at harming themselves, whose motivation is self injury but not death, but also those who have made an unsuccessful serious suicide attempt.

    The study has important lessons. Clearly most patients …

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