A qualitative study of multiple voices to inform aftercare services for older persons following self‐harm. (19th January 2023)

• Record Type: Journal Article
• Authors: Wand, Anne P.; Karageorge, Aspasia; Browne, Roisin; Jessop, Tiffany; Peisah, Carmelle
• Is Part Of: International journal of geriatric psychiatry. Volume 38:Number 1(2023)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2023-01-19
• Subjects: aged -- improvement -- prevention -- self‐harm -- suicide; Geriatric psychiatry -- Periodicals; Geriatric Psychiatry -- Periodicals; 618.97689
• DOI: 10.1002/gps.5876
• Languages: English
• ISSNs: 0885-6230

Abstract

Abstract: Objectives: Self‐harm and suicide are closely related in older adults, highlighting the opportunity for Aftercare interventions in targeted suicide prevention. The study aims were to explore strengths and shortfalls of current Aftercare services for older adults from the perspective of key stakeholders and researchers; and inform a set of guiding principles for older persons' Aftercare. Methods: Semi‐structured interviews were undertaken with a convenience sample of older people with lived experience of self‐harm, clinicians and suicide researchers ( n = 22). Interviews were focussed on current practice (strengths and limitations), potential improvements, and identifying the core components of an acceptable Aftercare model. Interviews were audio‐recorded, transcribed and subjected to a reflexive thematic analysis grounded in interpretive description. Results: Current practice strengths included validation, a person‐centred approach and optimising aftercare delivery. Limitations included ageism, practical limitations (lack of service awareness, fragmented service provision, barriers to access, and traumatising approaches), and limited services, funding and training. Overarching themes included anti‐ageism; anti‐stigma; empowerment and agency; conveying hope; patience and pace; accessible; and finding purpose: connections and meaningful activity. Conclusions: Older people who have self‐harmed have complex, individualised needs. They sit within intersecting systems traversing healthcare, support services, family, and the social environment. Systemic, coordinated Aftercare founded upon core principles of anti‐ageism, anti‐stigma, partnership, empowerment, accessibility and provision of connections and meaning are needed. Key points: Older people who have self‐harmed need a dedicated, evidence‐based approach to Aftercare. Key stakeholders and researchers value Aftercare which is person‐centred, validating, and optimises service delivery. Identified limitations of current Aftercare services include ageism, practical limitations, and limited services, funding and training. The derived core principles for Aftercare include anti‐ageism, anti‐stigma, empowerment and agency, conveying hope, patience and pace, accessibility and finding purpose.