Home | News | Window of opportunity missed? Study points to lack of referral for older adult self-harm

Window of opportunity missed? Study points to lack of referral for older adult self-harm

Few older adults who self-harm in the UK are being referred for a specialist mental health assessment following a GP visit, a new study has found.

Published in The Lancet Psychiatry journal, the large observational study found that around 90 per cent of seniors who had harmed themselves, including overdosing on prescription drugs or self-cutting, weren’t referred on.

Study lead Dr Cathy Morgan, from the University of Manchester, said older adults often face a decline in functional ability due to multiple comorbid conditions, bereavement and social isolation, which are all strongly linked with self-harm.

During the 13-year study period, 4,124 adults aged 65 years or older had an episode of self-harm recorded in general practice patient notes.

Drug overdose was the most common method of self-harm (81 per cent), followed by self-cutting (6 per cent).

Professor Carolyn Chew-Graham from Keele University said since drug ingestion is one of the main methods of self-harm, the research “highlights the need to prescribe less toxic medication in older adults for the management of both mental illness and pain related conditions”.

Chew-Graham said: “We also recommend more frequent follow-up of a patient following an initial episode of self-harm.”

The study found one in seven older adults self-harmed again within a year of the initial episode.

Co-author Professor Nav Kapur said self-harm is not just a problem for younger people. “We hope our study will alert clinicians, service planners, and policy makers to the need to implement preventative measures for this potentially vulnerable group of people,” Kapur said. “Referral and management of mental health conditions are likely to be key.”

Australian researcher Associate Professor Rebecca Mitchell from Macquarie University said further research needs to be done on self-harm among older adults, including the replication of the UK research in other countries.

“Exploration of self-harm and suicide risk among older adults in long-term care facilities has been scant,” Mitchell said. “Little is known regarding the factors that might influence or be protective of the risk of self-harm among residents in long-term care compared with older adults living in the general community.”

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