admit their anger towards people who self-harm, conference hears
by Angela Hussain
should admit their feelings of disgust and anger towards people
who self-harm, delegates at a conference were told yesterday.
so will help stop them acting in a punitive way towards people who
self-harm, psychiatrist Leonard Fagin said at the annual conference
of the Royal College of Psychiatrists in Edinburgh.
comments come after psychminded revealed last year that psychiatrists
had fiercely criticised colleagues who described self harming patients
as "willfully immature" and who "seem to thrive on
the chaos they cause and attention they receive." The
rebukes were posted on the discussion board of doctors.net.uk, an
online resource for psychiatrists and other doctors.
year, the National Institute for Mental Health issued guidelines
stating that professionals should treat people who self harm with
the same respect as they would any other patient.
Dr Fagin, a consultant psychiatrist at South Forest Centre in London,
emphasised that mental health and A&E staff are not receiving
appropriate support when working with people who self harm.
government guidance that practitioners should avoid a punitive approach
to self harm, health care staff are still too quick to condemn or
dismiss this group of patients," he said.
are especially vulnerable to becoming involved in an emotional maelstrom
when a patient hits a self-harm crisis because they are not receiving
the support they need."
Fagin said a solution was for practitioners to talk openly about
negative feelings that prompt them to act in a punitive way.
who treat those who self-harm have to find an approach to therapy
that is not accusing, critical or hopeless - which is caring yet
not easy to do and it is not helpful for people to have to pretend
that powerful feelings of anger, hatred, rage and revulsion do not
exist. Professionals need be able to own up to these feelings at
group meetings with colleagues."
Fagin added that he was concerned that surveys continue to show
that training in treating self-injury is not good enough.
speaker, Dr Paul Gill, a community psychiatrist at Longley Centre
in Sheffield, said it was vital to establish protocols between different
professional groups within the NHS in treating people who self-harm.
is evidence that inter-professional rifts prevent self-harm patients
receiving optimal care. A&E staff, for instance, often think
that psychiatrists will be reluctant to attend a self-harm patient
and will be slow to respond, and that when they do arrive, their
decisions may be incomprehensible.
pick up on this hostility and the victims are the patients. The
evidence shows that when care pathways are agreed, rates of self-harm
go down,' he said.
Clinical psychology comment
13, 2004: The usefulness of self harm - Self harm can be an
imaginative way to cope with trauma. To avoid shaming people who
self harm clinical psychologists should not assume that self harm
is wrong, argues Sam Warner
26, 2004: Psychiatrists rebuke colleagues over remarks on self harming
patients - concern after people who self harm described as "willfully
29, 2004: Treat people who self harm with respect, new guideline
urges professionals - A&E staff should also receive specialist
training, NICE recommends
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