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Dr Tracey McDonald AM PhD FACN, Professor of Ageing, 2011

Dear Colleagues

Many of you will remember my research in late 2007 (For their sake: Can we improve the safety of transfers between hospital and aged care, McDonald 2007. (For_their_sake_REPORT.pdf) which showed that hospital doctors and nurses harbor discriminatory and callous attitudes towards older patients transferred from aged care homes for hospital treatment. Well, it seems that hospital clinicians also don't like people who self-harm. Attitudes of health professionals lie at the heart of quality and safety in care and treatment so if this is true, then it is an important issue for all involved in accessing health care or the caring professionals providing it.

A systematic review from Oxford University Centre for Suicide Research explored health services staff attitudes towards people who self-harm and found 74 (English language only) studies on the issue that met their inclusion criteria.

Briefly the reviewers found that:

  • Attitudes of general hospital staff, especially doctors, were largely negative, particularly towards individuals who repeatedly self-harm
  • Self-harm patients were viewed more negatively than other patients, except those abusing alcohol or drugs
  • Psychiatric staff in community and hospital settings displayed more positive attitudes than general hospital staff
  • Negative attitudes were more common among doctors than nursing staff although this was only true of general hospital staff
  • Active training led to consistent improvements in attitude and knowledge in all groups.

The conclusion of the researchers was that the negative attitudes of hospital clinicians towards patients who self-harm mirror the experiences of service users. Still, they found that interventions such as staff training and proper supervision of clinical staff can improve the quality and safety of patient care.

Saunders KE, Hawton K, Fortune S, Farrell S. Attitudes and knowledge of clinical staff regarding people who self-harm: A systematic review. J Affect Disord. 2011 Sep 16. [Epub ahead of print] The abstract can be accessed at:

Last updated 18/11/2019
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