Deliberate Self-harm in Adolescents and Young Adults
A major problem in the care of adolescents who self-harm or are suicidal is that PCPs may have difficulty dealing with these intentional acts. The intentional nature of the behavior can be difficult for providers to understand and to accept when they are dealing with potentially life-threatening problems of other clients or when their own anxieties about the behavior interfere with providing compassionate care. The education of all health professionals needs to include opportunities to examine feelings about DSH behaviors, gain some understanding about the factors that influence these behaviors, and receive education about appropriate responses for the level of care they will be providing. Assessment, identification, and treatment of DSH in the adolescent and adult population need to be included.
Student nurses and NPs need to understand the issue of DSH and should be taught how DSH presents, the underlying risk factors, and the evidence-based management strategies. Student nurses should also be taught specific red flags for to look for when assessing the young adult that would better equip them to identify and counsel patients exhibiting the risk or behaviors of DSH. Finally, they need to be taught how and when to refer DSH patients for further care.
At the graduate level, advanced practice nurses need detailed information on the assessment, psychosocial factors, psychological factors, peer association, and evidence-based management strategies to properly provide comprehensive primary care. A good understanding of child abuse, anxiety and depressive disorders, stress-related illness, and peer association cues should be part of the advanced practice curriculum.
Neville and Poustie recognized the need for greater training and support for all members of the primary health care team as part of continuing education. Taylor et al noted that PCPs need improved knowledge, communication, and follow-up, thus compounding the need for further assessment of the educational and health care system to identify where knowledge and experience could be attained.
Nursing Education Implications
A major problem in the care of adolescents who self-harm or are suicidal is that PCPs may have difficulty dealing with these intentional acts. The intentional nature of the behavior can be difficult for providers to understand and to accept when they are dealing with potentially life-threatening problems of other clients or when their own anxieties about the behavior interfere with providing compassionate care. The education of all health professionals needs to include opportunities to examine feelings about DSH behaviors, gain some understanding about the factors that influence these behaviors, and receive education about appropriate responses for the level of care they will be providing. Assessment, identification, and treatment of DSH in the adolescent and adult population need to be included.
Student nurses and NPs need to understand the issue of DSH and should be taught how DSH presents, the underlying risk factors, and the evidence-based management strategies. Student nurses should also be taught specific red flags for to look for when assessing the young adult that would better equip them to identify and counsel patients exhibiting the risk or behaviors of DSH. Finally, they need to be taught how and when to refer DSH patients for further care.
At the graduate level, advanced practice nurses need detailed information on the assessment, psychosocial factors, psychological factors, peer association, and evidence-based management strategies to properly provide comprehensive primary care. A good understanding of child abuse, anxiety and depressive disorders, stress-related illness, and peer association cues should be part of the advanced practice curriculum.
Neville and Poustie recognized the need for greater training and support for all members of the primary health care team as part of continuing education. Taylor et al noted that PCPs need improved knowledge, communication, and follow-up, thus compounding the need for further assessment of the educational and health care system to identify where knowledge and experience could be attained.
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