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Attention MH professionals #MedTwitter #MedEd @rcpsychTrainees @rcpsych
A thread on why this is a paper you should be reading, using in teaching, sharing with your students, trainees and discussing in journal clubs
(TW: self harm and suicide) 1/7 https://twitter.com/RoseMcCabe2/status/1324634532738453506
A thread on why this is a paper you should be reading, using in teaching, sharing with your students, trainees and discussing in journal clubs
(TW: self harm and suicide) 1/7 https://twitter.com/RoseMcCabe2/status/1324634532738453506
The paper explores how doctors ask about self harm and suicide in primary care. It uses Conversation Analysis (CA) which looks systematically at interaction, ie: what was said and how it was said. CA is powerful methodology in identifying patterns in healthcare communication 2/7
Ask yourself how often is a paper published that looks in detail at something so fundamental to what we do every single day mental health services? And how often does your journal club analyse a qualitative paper and learn about different qual methodologies? 3/7
This study found that Qs about self-harm and suicide in primary care tend to be framed to elicit a “no” response. eg: “But you’ve not had any thoughts of harming yourself or suicide or anything like that.” This makes it hard for patients to answer affirmatively 4/7
Qs about thoughts of self-harm and suicide were often amalgamated (although these are very different experiences). There is also a tendency to be action focussed; ie: treating self-harm thoughts as a practical problem rather than a chance for empathic, therapeutic discussion 5/7
Why is this important? Because understanding, discussing, "managing" suicide or self-harm thoughts is always a conversation. We need to be able to ask Qs in a way that communicates we are ready to hear how someone is truly feeling, offer a space for their darkest thoughts 6/7
And to respond compassionately, without perpetuating shame and in a way that shows we can contain this information. Qs for MH professionals & GPs is how can we do this in practice? How might lack of time, resources and our own anxiety affect how we frame Qs? To be discussed...7/7
