A series of 80 patients who had deliberately but not fatally harmed themselves and had been admitted to hospital was examined with special reference to their use of available services during the period of distress prior to the episode. They were followed up for 4 months and the ways in which they subsequently made use of helping agencies were also monitored.
Three broad groups of patient attitudes to help and its utilization are described. ‘General practitioner help-seekers’ (29) defaulted least often and appeared to have more positive attitudes towards seeking help for their problem. The ‘psychiatric help-seekers’ (17) appeared to be a chronically disorganized group who, though previously often in treatment, seemed unable to cooperate: they defaulted frequently and apparently gained little. ‘Non-help-seekers’ (34) had been reluctant to ask for help concerning psychological problems and subsequently defaulted just as frequently as did the ‘psychiatric help seekers’.
The need to take into account variation in patient attitude to help and its utilization in designing services for the primary prevention of non-fatal deliberate self-harm is emphasized.