Knowledge, attitudes and practices of mental healthcare workers in management of intentional self-harm in a mental health care referral facility: a qualitative study

Abstract

Background: Intentional Self-Harm (ISH) contributes to a significant disease burden globally. Despite the urgent need for effective treatment, health care workers lack adequate training on ISH. Evidently, there is a correlation between attitude and practice that could determine ISH treatment outcomes.
Objective: To explore the knowledge, attitudes and practices of mental health care workers towards ISH in a mental health referral facility.
Main Outcome Measures: Saturation of themes for in-depth description of knowledge, attitude and practices regarding ISH.
Methods: This was qualitative research whereby a non-probability purposive sampling technique was used to identify participants for interviewing. Audio recorded data was transcribed verbatim and uploaded on the QSR International NVivo version 10 software for analysis.
Results: The study highlighted inadequacy in training and supervision of the psychiatric doctors. Negative attitude towards ISH patients was highlighted. Absence of ISH treatment guidelines and lack of collaboration in patient care was identified. ISH management was also described as challenging due to factors like stigma, poverty and shortage of staff.
Conclusion: Knowledge and competence on ISH intervention could be enhanced through effective training and mentorship. Regardless, ISH was not adequately covered in the curriculum and consultant psychiatrists had limited time for training resident doctors. Despite the majority of Mental health care workers demonstrating positive attitude towards ISH patients, some had negative attitudes. In practice, lack of collaborative care model and guidelines contributed to challenges in management of ISH. Other factors hindering ISH management were stigma, poverty and institutional challenges like staff shortage.