How can general practitioners help young people avoid future self-harm? a qualitative study.

Background Self-harm is a growing problem in young people. General practitioners (GPs) are usually the first point of healthcare contact for young people aged 16-25 years after self-harm. GPs can experience barriers to supporting young people and behaviour change theory can help to understand these barriers, and the influences on GP behaviour. Aim To explore and understand the capabilities, opportunities, and motivations (COM-B) of GPs, and their perceived training needs, to help young people aged 16-25 years avoid future self-harm. Design and setting A qualitative study in NHS general practice in England Method Semi-structured interviews were conducted with GPs and purposive sampling used to aim for a diverse sample. Interviews occurred in 2021. Data were analysed using reflexive thematic analysis and mapped onto COM-B model. The study patient and public involvement and community of practice groups supported data analysis. Results Fifteen interviews were completed (mean duration - 38 minutes). GPs described mixed capabilities, with many feeling they had the physical and psychological skills to support young people to avoid future self-harm, but some felt doing so was emotionally tiring. GPs identified opportunities to better support young people such as use of electronic consultation tools but cited lack of time as a concern. GPs reported motivation to help young people, but this was influenced by their daily workload. Unmet training needs around communication, knowledge, and optimising safety were identified. Conclusion Future GP-led interventions need to improve the capabilities, opportunities, and motivations of GPs to support young people to avoid future self-harm.