Rapid response pathway united to reduce self-harm (RUSH): a case study of a pilot pathway for children and young people

2022 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Molly Cross ◽  
Tim Clarke
Keyword(s):  
At Risk ◽  
Young People ◽  
User Satisfaction ◽  
Emergency Departments ◽  
Rapid Response ◽  
Framework Analysis ◽  
Children And Young People ◽  
Content Type ◽  
Self Harm

Purpose In response to elevated local self-harm and suicide rates, and the lack of a dedicated pathway for children and young people (CYP) who self-harm, a rapid response pathway united to reduce self-harm (RUSH) was developed and implemented within Norwich (Norfolk, England). This public health case study aims to describe the pathway model and share its outcomes, learnings, and reflections over the pilot year. Design/methodology/approach RUSH was a community-based pilot pathway aiming to support CYP, 11–18 years old, engaging in or at risk of engaging in repeated self-harm and subsequently at risk of repeated attendance at local emergency departments. From May 2020 to April 2021, RUSH supported 61 CYP using funding from NHS England and Improvement. Findings This case study shares the pathway’s outcomes, through a mixed-method evaluation. Results indicate statistically significant reductions in self-harm frequency (p = 0.01) and anxiety and depression symptomatology (p < 0.001); a statistically significant increase in progress towards goals (p < 0.001); and a general downward trend in re-attendance at local emergency departments following RUSH. Findings also illustrate high service user satisfaction. Framework analysis of focus group data highlights positive experiences with hope for recommissioning from a staff perspective. Originality/value This study will be valuable for services looking to develop and implement a similar service provision, in response to the need to tackle self-harm rates as a broader approach to suicide prevention. In light of the NHS long-term plan (2019), it also serves as an example of how to develop and use a strategic co-production group, and work collaboratively with the voluntary, community and social enterprise sectors.

Information-Seeking on the Internet

Crisis ◽  
2015 ◽  
Vol 36 (3) ◽  
pp. 211-219 ◽  
Author(s):  
Vinod Singaravelu ◽  
Anne Stewart ◽  
Joanna Adams ◽  
Sue Simkin ◽  
Keith Hawton
Keyword(s):  
At Risk ◽  
Young People ◽  
Information Seeking ◽  
Significant Proportion ◽  
The Internet ◽  
Search Terms ◽  
Specific Advice ◽  
Restriction Sites ◽  
Self Harm ◽  
Negative Tone

Abstract. Background: The Internet is used by young people at risk of self-harm to communicate, find information, and obtain support. Aims: We aimed to identify and analyze websites potentially accessed by these young people. Method: Six search terms, relating to self-harm/suicide and depression, were input into four search engines. Websites were analyzed for access, content/purpose, and tone. Results: In all, 314 websites were included in the analysis. Most could be accessed without restriction. Sites accessed by self-harm/suicide search terms were mostly positive or preventive in tone, whereas sites accessed by the term ways to kill yourself tended to have a negative tone. Information about self-harm methods was common with specific advice on how to self-harm in 15.8% of sites, encouragement of self-harm in 7.0%, and evocative images of self-harm/suicide in 20.7%. Advice on how to get help was given in 56.1% of sites. Conclusion: Websites relating to suicide or self-harm are easily accessed. Many sites are potentially helpful. However, a significant proportion of sites are potentially harmful through normalizing or encouraging self-harm. Enquiry regarding Internet use should be routinely included while assessing young people at risk.

A systematic review into healthcare professionals’ attitudes towards self-harm in children and young people and its impact on care provision

2021 ◽  
pp. 136749352110144
Author(s):  
Lea Raquel Ribeiro Coimbra ◽  
Amy Noakes
Keyword(s):  
Young People ◽  
Healthcare Professionals ◽  
Educational Opportunities ◽  
Emotional Impact ◽  
Valuable Insight ◽  
Care Provision ◽  
Children And Young People ◽  
Positive Attitudes ◽  
Self Harm ◽  
Impact Patient Care

Self-harming behaviours in children and young people are an alarming reality, with provision of effective treatment historically compromised. The present systematic literature review highlights attitudes displayed by healthcare professionals towards this health problem, providing valuable insight by analysing how these attitudes can impact patient care. Ten studies were included, allowing creation of a narrative synthesis of qualitative, quantitative and mixed-methods evidence. Six themes emerged: negativity, positivity, worry or fear, the emotional impact of working with these patients, professional roles and ward-dependent concerns. Overall, professional negativity towards this patient group, in the form of apprehensiveness, was accentuated by fear of worsening their symptoms. The attitude aforementioned impacts on treatment by hindering creation of meaningful therapeutic relationships. Educational opportunities that increase healthcare professionals’ knowledge of self-harm have the potential to provide invaluable power by promoting positive attitudes.

No Harm Done – dispelling myths, giving hope and practical help for young people, parents and professionals affected by self-harm

2016 ◽  
Vol 15 (3) ◽  
pp. 134-135 ◽  
Author(s):  
Marc Bush
Keyword(s):  
Young People ◽  
Design Methodology ◽  
Parent Engagement ◽  
Life Experiences ◽  
Real Life ◽  
Content Type ◽  
Practical Advice ◽  
Short Films ◽  
Self Harm ◽  
The Way

Purpose The No Harm Done films provide hope and give support to those affected by self-harm. The accompanying digital packs dispel myths, answer frequently asked questions, provide practical advice and signpost to further help and support. The paper aims to discuss these issues. Design/methodology/approach YoungMinds employed its sector-leading expertise in youth and parent engagement. Both the films and digital packs were co-created with young people, parents and professionals, reflecting their real-life experiences of self-harm. Findings The project responded to young people who self-harm telling us they feel isolated, alone, in need of hope and help to counteract the negative and frightening messages widely available online. Parents confided they also feel isolated and that it is their fault their child is harming themselves. Teachers told us they see the signs but cannot bring themselves to say anything, and even if they want to, they cannot find the words to reach out to young people. Originality/value Quote from a professional “I personally found the No Harm Done short films to be incredibly valuable resources for my practice with young people. The way the films have been produced will make it a lot harder for young people that I work with to judge the action of self-harm given that there are no graphic harming words/stories and the films themselves do not come across as triggering. I feel enthusiastic that these films will encourage understanding and empathy from peers and spark conversation enabling those who have no knowledge around self-harm to be more accepting, open and supportive of those who have issues with self-harm.”

scholarly journals Inclusive school practices supporting the primary to secondary transition for autistic children: pupil, teacher, and parental perspectives

2018 ◽  
Vol 4 (4) ◽  
pp. 184-196 ◽  
Author(s):  
Keri Hoy ◽  
Sarah Parsons ◽  
Hanna Kovshoff
Keyword(s):  
Young People ◽  
Secondary School ◽  
School Transition ◽  
Effective Practices ◽  
Small Scale ◽  
Autistic Children ◽  
Content Type ◽  
Secondary School Transition ◽  
Practical Implications

Purpose The primary to secondary school transition can have a significant and long-lasting impact on young people. Autistic children are particularly vulnerable to negative transition experiences; however, there is a lack of research examining effective practices and provision for these pupils. This case study involves a mainstream secondary school in the South of England, which has a dedicated Learning Support base. The purpose of this paper is to collect qualitative data on experiences of the primary to secondary school transition from multiple stakeholders. Design/methodology/approach A photovoice activity followed by a semi-structured interview was conducted with five autistic pupils aged 12–16 years; semi-structured interviews were also carried out with six parents and four teachers. Findings Five key themes emerged from the data in relation to effective practices: inclusion, child-centred approach, familiarisation, visual supports and communication and consistency. Research limitations/implications As a small-scale case study, there are limitations regarding generalisation. However, this research illuminates transition practices that are experienced as effective by autistic children, their families and teachers. Practical implications Practical implications related to each of these themes are highlighted. These implications are important in the context of the mandatory responsibilities of schools in England to include the voices of children and young people with special educational needs in decisions about their education. Originality/value The findings challenge a rights-based approach to inclusion and illustrate the importance of a needs-based approach which appropriately recognises and understands what autism means for children, their families and the teachers who support them.

scholarly journals Assessing young people who deliberately harm themselves

2000 ◽  
Vol 176 (2) ◽  
pp. 126-131 ◽  
Author(s):  
Jane Hurry ◽  
Pamela Storey
Keyword(s):  
At Risk ◽  
Young People ◽  
Service Management ◽  
Postal Questionnaire ◽  
Psychosocial Assessment ◽  
Old Patients ◽  
Admission Rates ◽  
Accident And Emergency ◽  
Patients At Risk ◽  
Self Harm

BackgroundMany young people who harm themselves have chronic mental health or social problems or are at risk of future self-harm or even suicide. The accident and emergency (A&E) clinic is an important gateway to treatment.AimsTo describe the psychosocial assessment of 12- to 24-year-old patients attending A&E clinics following deliberate self-harm (DSH) and to identify features of service management and provision which maximise specialist assessment.MethodA postal questionnaire was sent to a sample of one in three A&E departments in England. In a representative sample of 18 of these hospitals, staff were interviewed and 50 case notes per hospital were examined.ResultsPsychosocial assessment by non-specialist doctors in A&E departments tended to be of variable quality, focused on short-term risk. Around 43% of patients aged 12–24 were assessed by a specialist; specialist assessment was associated with high admission rates and the presence of on-site psychiatric departments and DSH teams.ConclusionsYoung DSH patients at risk often go unidentified; as a result their psychological problems may not be treated. Hospitals are frequently unaware of the proportion of patients discharged without adequate assessment.

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