Managing people who self-harm: what does the qualitative literature say?

Paramedics encounter growing numbers of people who self-harm and the authors identify that frequently these service-users report care and attitudes from healthcare staff as being unsatisfactory. However, it appears that paramedics and emergency care staff's role in these patients' care is under researched.

Previously, Rees et al (2014) have reported the findings of a systematic review of the quantitative literature on this topic, so this paper focuses on a review of qualitative research, exploring perceptions of paramedics and emergency care staff to patients who self-harm.

Using key search terms such as ‘self-harm’, ‘suicide’, ‘paramedic’, ‘emergency’, ‘overdose’, ‘pre-hospital’, ‘mental health’, ‘ambulance’, and ‘perceptions of care’, combined with processes of manual searching as well as searching electronic databases such as CINAHL®, OVID®, Psych INFO® and MEDLINE®, a total of 1 137 citations were identified. Having removed all duplicates, 734 papers remained.

Ultimately, 12 papers met the criteria for inclusion while 722 were excluded: 635 had no relevance to emergency or pre-hospital care; 52 did not focus on perceptions of care; 12 did not have relevant participants; five used quantitative methods; three focused on specialist mental healthcare workers; and the lead researcher was unable to retrieve a total of 15 papers.