Box 3.

Recommendations to GPs working with older people who self-harm

Be aware that self-harm can occur in older adults, and though suicidal intent is not always present, it is important to consider patients’ suicidality Consider the stigma attached to self-harm, and ensure an empathic approach so that the patient feels listened to Be responsive to the distress associated with self-harm; do not focus exclusively on the physical sequelaeof self-harm Consider offering longer appointments to provide comprehensive assessment and support to the patient for physical and mental health needs Consider arranging a follow-up as part of ongoing assessment and management Review current medication to assess whether these may act potentially as a method of self-harm, for example, overdose Assess patient safety throughout the consultation and advise on access to means of potential self-harm Liaise with the third sector and social care sector, or refer to specialist care where indicated View the consultation as an opportunity to provide self-harm management and avoid repeat self-harm and suicide