Chronic substance use and self-harm in a primary health care setting

African Journal of Primary Health Care & Family Medicine

 
 
Field Value
 
Title Chronic substance use and self-harm in a primary health care setting
 
Creator Breet, Elsie Bantjes, Jason Lewis, Ian
 
Subject primary health care; primary care substance abuse; suicidal behaviour; self-harm; primary care service utilisation
Description Background: Chronic substance use (CSU) is associated with health problems, including selfharm, placing a significant burden on health care resources and emergency departments (EDs). This is problematic in low- and middle-income countries like South Africa (SA), where primary care facilitates and emergency departments (EDs) are often poorly resourced.Aim: To investigate the epidemiology of CSU and self-harm and to consider the implications for primary health care service delivery and suicide prevention in SA.Methods: Data were collected from 238 consecutive self-harm patients treated at the emergency department (ED) of an urban hospital in SA. The data were analysed using bivariate and multivariate analyses.Results: Approximately 37% of self-harm patients reported CSU. The patients in the CSU subgroup, compared to other self-harm patients, were more likely to be men (odds ratio[OR] = 8.33, 95% confidence interval [CI] = 3.19–20.9, p 0.001), to have self-harmed by inflicting damage to their body tissue OR = 4.45, 95% CI = 1.77–11.2, p 0.01) and to have a history of self-harm (OR = 3.71, 95% CI = 1.44–9.54, p = 0.007). A significantly smaller proportion of CSU patients, compared to other self-harm patients, were referred for psychiatric assessment (OR = 8.05, 95% CI = 4.16–15.7, p 0.001).Conclusion: The findings of this study confirm that CSU is associated with greater service utilisation and repetition of self-harm among patients in primary health care settings. Treating self-harm as the presenting problem within primary care settings does not necessarily ensure that patients receive the care that they need. It might be helpful to include psychiatric assessments and screening for CSU as an integral component of care for self-harm patientswho present in primary health care settings.
 
Publisher AOSIS
 
Contributor National Research Foundation South African Medical Research Council
Date 2018-06-19
 
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — quantitative study
Format text/html application/epub+zip application/xml application/pdf
Identifier 10.4102/phcfm.v10i1.1544
 
Source African Journal of Primary Health Care & Family Medicine; Vol 10, No 1 (2018); 9 pages 2071-2936 2071-2928
 
Language eng
 
Relation
The following web links (URLs) may trigger a file download or direct you to an alternative webpage to gain access to a publication file format of the published article:

https://phcfm.org/index.php/phcfm/article/view/1544/2693 https://phcfm.org/index.php/phcfm/article/view/1544/2692 https://phcfm.org/index.php/phcfm/article/view/1544/2694 https://phcfm.org/index.php/phcfm/article/view/1544/2660 https://phcfm.org/index.php/phcfm/article/downloadSuppFile/1544/2832
 
Coverage Africa; South Africa; Western Cape; Observatory June 2014-March 2015 Age; Gender; Ethnicity; Patients admitted following self-harm
Rights Copyright (c) 2018 Elsie Breet, Jason Bantjes, Ian Lewis https://creativecommons.org/licenses/by/4.0
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