Clinical management of women who self-wound: A survey of Mental Health professionals' preferred strategies

Abstract

Aim: To evaluate professional opinion of various strategies advocated for the clinical management of self-wounding in female patients. Method: A postal survey of all 386 NHS staff working within multi-disciplinary teams in one English county using a specially developed questionnaire assessing preferred management of a case described in a vignette. Results: A return of 55% (n =213) was achieved, with 94% of respondents reporting direct clinical contact with women who had self-wounded. Responses were scored according to the extent to which respondents endorsed each of 19 management strategies. The strategies of maintaining regular discussion amongst involved staff and of encouraging the client to ventilate unexpressed feelings were seen as the most helpful, with medication and hospital admission regarded as unhelpful. Ambivalence and uncertainty were evident for many of the suggested strategies. Conclusions: A range of opinion has been demonstrated amongst a multi-disciplinary group of mental health professionals towards managing self-wounding. Difference of opinion about the value of several of the suggested regimes tended to match the disparity in the literature, could not generally be explained in terms of the gender, experience or training of the respondent, and implies a potential for disagreement amongst a body of staff. It is suggested that the strong preference for maintaining regular discussion between involved staff may help to minimise management difficulties for this client group.