scholarly journals Comparing short-term risk of repeat self-harm after psychosocial assessment of patients who self-harm by psychiatrists or psychiatric nurses in a general hospital: Cohort study

2020 ◽  
Vol 272 ◽  
pp. 158-165
Author(s):  
Alexandra Pitman ◽  
Apostolos Tsiachristas ◽  
Deborah Casey ◽  
Galit Geulayov ◽  
Fiona Brand ◽  
...  
2010 ◽  
Vol 34 (6) ◽  
pp. 226-230 ◽  
Author(s):  
Nicholas Holdsworth ◽  
Hugh Griffiths ◽  
David Crawford

Aims and methodAlthough alcohol is reported as commonly associated with self-harm, there is nothing in the literature that bases the association on validated screening tools. We sought to discern the different types of alcohol use as discriminated by the Alcohol Use Disorders Identification Test (AUDIT). Completed AUDITs from a 2-year period were analysed, all relating to people who had presented to a district general hospital in Northumberland following self-harm.ResultsThe proportion of dependent, harmful and hazardous drinkers identified using AUDIT was many times higher than previously estimated in similar studies that had not used a validated alcohol screening tool.Clinical implicationsThe routine use of an alcohol screening tool should be part of any standard psychosocial assessment of self-harm, to guide appropriate interventions for problematic alcohol use that might otherwise be overlooked.


Crisis ◽  
2004 ◽  
Vol 25 (4) ◽  
pp. 183-186 ◽  
Author(s):  
Rachel Crowder ◽  
Rohan Van Der Putt ◽  
Ceri-Anne Ashby ◽  
Andrew Blewett

Abstract: Deliberate self-harm patients who leave the acute hospital environment before the completion of psychiatric assessment have an increased risk of subsequent self-harm. We considered the available data on 50 premature self-discharges identified prospectively in a general hospital with a well-developed integrated-care pathway for self-harm patients, and compared them to a control group. The self-discharge group was found to be more likely to have attempted self-poisoning without alcohol intoxication or other forms or combinations of self-harm, and an absence of identifiable previous self-harm or prior contact with local specialist psychiatric services. The two groups showed no difference in age, sex, or area of residence based on community mental health team sectors. It is proposed that these findings indicate hypotheses for further studies of why people leave the hospital without adequate assessment, and how service design could be improved in order to help them.


2017 ◽  
Vol 258 ◽  
pp. 421-426 ◽  
Author(s):  
Yoko Yoshida Kawahara ◽  
Satoshi Hashimoto ◽  
Masahiro Harada ◽  
Daisuke Sugiyama ◽  
Shu Yamada ◽  
...  

2008 ◽  
Vol 192 (6) ◽  
pp. 440-445 ◽  
Author(s):  
Rachael Lilley ◽  
David Owens ◽  
Judith Horrocks ◽  
Allan House ◽  
Rachael Noble ◽  
...  

BackgroundQuantitative research about self-harm largely deals with self-poisoning, despite the high incidence of self-injury.AimsWe compared patterns of hospital care and repetition associated with self-poisoning and self-injury.MethodDemographic and clinical data were collected in a multicentre, prospective cohort study, involving 10 498 consecutive episodes of self-harm at six English teaching hospitals.ResultsCompared with those who self-poisoned, people who cut themselves were more likely to have self-harmed previously and to have received support from mental health services, but they were far less likely to be admitted to the general hospital or receive a psychosocial assessment. Although only 17% of people repeated self-harm during the 18 months of study, survival analysis that takes account of all episodes revealed a repetition rate of 33% in the year following an episode: 47% after episodes of self-cutting and 31% after self-poisoning (P<0.001). Of those who repeated, a third switched method of self-harm.ConclusionsHospital services offer less to people who have cut themselves, although they are far more likely to repeat, than to those who have self-poisoned. Attendance at hospital should result in psychosocial assessment of needs regardless of method of self-harm.


2006 ◽  
Vol 23 (3) ◽  
pp. 92-95
Author(s):  
Larkin Feeney ◽  
Annette Kavanagh ◽  
Mary Mooney ◽  
Stephen Browne

AbstractObjective: The evaluation of psychosocial need is an important part of the assessment of any patient who presents to a psychiatrist. The Camberwell Assessment of Need (CAN) instrument was developed for the systematic assessment of need in people with severe and enduring mental illness. Variations of the CAN have been developed for forensic, elderly and learning disability populations. Patients presenting to psychiatrists in the general hospital may also have different needs to those presenting to psychiatrists in other settings. We set out to examine whether the CAN would be useful in identifying needs in patients referred to psychiatrists in the general hospital with self-harm or alcohol problems.Method: Over a four-month period from September 2004 we prospectively assessed all patients with self-harm or alcohol problems referred to a liaison psychiatry service. We used the short version of the Camberwell Assessment of Need instrument (CANSAS) to assess psychosocial needs. Urgent referrals to a local psychiatric service of patients with severe enduring mental illness (SEMI) were assessed using identical methodology over the same time period and used as a comparison group.Results: Over the study period 53 patients with self-harm, 42 with alcohol problems and 45 with SEMI were assessed. Patients presenting with self-harm and alcohol problems had significantly fewer needs than those with SEMI (4.40 vs 3.98 vs 7.96, p < 0.001). Looking after the home, self-care, daytime activity, psychotic symptoms, safety to others and sexual expression needs were significantly greater in the SEMI group than in either the DSH or alcohol groups. Only safety to self-needs in the DSH group and alcohol needs in the alcohol group were significantly higher than in the SEMI group. The proportion of needs that were unmet was similar in each group.Conclusions: The CANSAS instrument identified some needs in deliberate self-harm and alcohol problem patients that might not have been identified during the course of a standard psychosocial assessment. It was easy to administer and as such was a useful addition to the assessment process. However the development of a more specific instrument for the assessment of need in these populations would be useful.


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