Affiliation:
1. Specialty of Psychiatry Faculty of Medicine and Health University of Sydney Sydney New South Wales Australia
2. Discipline of Psychiatry and Mental Health Faculty of Medicine University of New South Wales Sydney New South Wales Australia
3. Older Persons Mental Health Service Sydney Local Health District Sydney New South Wales Australia
4. Brain and Mind Centre University of Sydney Camperdown New South Wales Australia
5. ForeFront Motor Neuron Disease & Frontotemporal Dementia Clinic Faculty of Medicine and Health University of Sydney Sydney New South Wales Australia
6. Capacity Australia Sydney New South Wales Australia
Abstract
AbstractObjectivesSelf‐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.MethodsSemi‐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.ResultsCurrent 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.ConclusionsOlder 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.
Subject
Psychiatry and Mental health,Geriatrics and Gerontology