Assessment and identification of deliberate self-harm in the adolescent and young adult patient in the primary care population.

摘要

Deliberate self-harm is a major public health concern among the adolescent and young adult population. Commonly, health care providers are not aware of the magnitude of the issue due to the fact that many adolescents and young adults who participate in the behavior do not present to the health care system for care. Health care providers lack basic knowledge related to the assessment and identification of deliberate self-harm therefore contributing to the lack of recognition. Diverse sources of literature suggest various underlying motives for participating in the behavior including history of abuse, psychologic disorders, and lack of coping skills. Self-harm behaviors even have been found to be behaviors learned from peers. Given the time restrictions and knowledge deficit on the health care providers part, a detailed physical, psychological, and psychosocial assessment is often excluded from both the well and acute visit for adolescents and young adults. The implications for the lack of identification of deliberate self-harm in the adolescent and young adult population includes, repetition of the behavior, worsening or continuation of the underlying issues including abuse, psychologic dysfunction, and family dysfunction, as well as the fact that it may even lead to an escalation of behaviors that result in suicide. Studies have found that several aspects should be addressed in the comprehensive assessment of the adolescent and young adult who is at risk or currently participating in deliberate self-harm behaviors.;It is important to utilize a targeted, comprehensive assessment to identify risk of and participation in deliberate self-harm. Guidelines are presented to assist in furthering the health care providers understanding of the essential components of the assessment of adolescents and young adults which will enhance the identification of deliberate self-harm in the primary care setting. Additionally, suggestions are provided to assist in answering the PICO question "Does a targeted comprehensive assessment influence identification of adolescents and young adults who deliberately self-harm in the primary care population?"