Psychosocial assessment of patients who attend an accident and emergency department with self-harm

2005 ◽  
Vol 12 (2) ◽  
pp. 130-138 ◽  
Author(s):  
W. BARR ◽  
M. LEITNER ◽  
J. THOMAS
Keyword(s):  
Emergency Department ◽  
Psychosocial Assessment ◽  
Accident And Emergency ◽  
Self Harm ◽  
Accident And Emergency Department

scholarly journals Increasing psychosocial assessment by introducing a self-harm pathway

2006 ◽  
Vol 30 (5) ◽  
pp. 169-172 ◽  
Author(s):  
Peter Lepping ◽  
Barbara Woodworth ◽  
Lucy Roberts ◽  
Jim Turner
Keyword(s):  
Emergency Department ◽  
The Self ◽  
Psychosocial Assessment ◽  
Clinical Implications ◽  
Protocol Adherence ◽  
Steering Group ◽  
Accident And Emergency ◽  
Before And After ◽  
Self Harm ◽  
Accident And Emergency Department

Aims and MethodTo audit whether the introduction of a self-harm pathway and protocol increases the number of psychosocial assessments. All episodes of self-harm in a defined period during 2002 (n=335) and 2004 (n=390) were reviewed before and after the introduction of a self-harm pathway and protocol. Adherence to the protocol was also investigated.ResultsAfter the introduction of the self-harm pathway and protocol, the proportion of psychosocial assessments requested had risen from 57% (2002) to 85% (2004). The proportion of psychosocial assessments completed had risen from 47% to 70%. Over the 2 years, the overall number of self-harm presentations was reduced by 27%.Clinical ImplicationsThe introduction of a self-harm pathway and protocol through a self-harm steering group is feasible, was well accepted and increased the number of psychosocial assessments after self-harm. It may also contribute to a reduction in the number of overall presentations with self-harm to the accident and emergency department.

scholarly journals Attendance at the accident and emergency department in the year before suicide: Retrospective study

2003 ◽  
Vol 183 (1) ◽  
pp. 28-33 ◽  
Author(s):  
Isaura Gairin ◽  
Allan House ◽  
David Owens
Keyword(s):  
Mental Health ◽  
Emergency Department ◽  
Mental Health Service ◽  
Health Service ◽  
Health Services ◽  
Emergency Departments ◽  
Accident And Emergency ◽  
Self Harm ◽  
Accident And Emergency Department ◽  
Service Contact

BackgroundThe National Confidential Inquiry into suicides in England and Wales found that a quarter of suicides are preceded by mental health service contact in the year before death. However, visits to accident and emergency departments due to self-harm may not lead to a record of mental health service contact.AimsTo determine the proportion of suicides preceded by accident and emergency attendance in the previous year.MethodWe obtained the list of probable suicides in Leeds for a 38-month period, and examined the records from thecity's accident and emergency departments for a year before each death.ResultsEighty-five (39%) of the 219 people who later died by suicide had attended an accident and emergency department in the year before death, 15% because of non-fatal self-harm. Final visits dueto self-harm were often shortly before suicide (median 38 days), but the National Confidential Inquiry recorded about a fifth of them as‘not in contact’ with local mental health services.ConclusionsAlthough many suicides are preceded by recent attendance at accident and emergency departments due to non-fatal self-harm, local mental health service records may show no recent contact. Suicide prevention might be enhanced were accident and emergency departments and mental health services to work together more closely.

scholarly journals Compliance with NICE guidelines in the management of self-harm

2010 ◽  
Vol 34 (9) ◽  
pp. 385-389 ◽  
Author(s):  
Diane Mullins ◽  
Siobhan MacHale ◽  
David Cotter
Keyword(s):  
Clinical Excellence ◽  
Psychosocial Assessment ◽  
Standards Of Care ◽  
Liaison Psychiatry ◽  
Single Male ◽  
Nice Guidelines ◽  
Accident And Emergency ◽  
Self Harm ◽  
Male Patients ◽  
Accident And Emergency Department

Aims and methodTo identify the provision of psychosocial assessments for all people attending an accident and emergency department in Ireland with a presentation indicative of self-harm over 12 months and to investigate whether the National Institute for Health and Clinical Excellence (NICE) guidelines for self-harm were met.ResultsA total of 834 attendances for self-harm were recorded. A psychosocial assessment was undertaken by a member of the liaison psychiatry team in 59% of attendances. Single male patients under 45 years of age represented 39% of those who did not receive a psychosocial assessment.Clinical implicationsSingle men under the age of 45 years represent a vulnerable group in which levels of psychosocial assessment need to be optimised in order to meet the NICE guidelines for standards of care.

scholarly journals Deliberate self-harm and antidepressant drugs

2000 ◽  
Vol 177 (6) ◽  
pp. 551-556 ◽  
Author(s):  
Stuart Donovan ◽  
Andrew Clayton ◽  
Min Beeharry ◽  
Sheron Jones ◽  
Chris Kirk ◽  
...  
Keyword(s):  
Emergency Department ◽  
Prospective Study ◽  
Serotonin Reuptake ◽  
Antidepressant Drugs ◽  
Tricyclic Antidepressant ◽  
Deliberate Self Harm ◽  
Accident And Emergency ◽  
Self Harm ◽  
Accident And Emergency Department ◽  
A Prospective Study

BackgroundIt is not clear if the frequency of deliberate self-harm (DSH) is the same in patients taking different pharmacological classes of antidepressant drugs.AimsTo compare the frequency of DSH in patients who had been prescribed a tricyclic antidepressant (TCA) or a selective serotonin reuptake inhibitor (SSRI) prior to the DSH event.MethodThis was a prospective study in 2776 consecutive DSH cases attending an accident and emergency department. The incidence of DSH in TCA-treated cases and SSRI-treated cases is expressed as number of DSH events per 10 000 prescriptions of each antidepressant.ResultsSignificantly more DSH events occurred following the prescription of an SSRI than that of a TCA (P < 0.001). The occurrence of DSH was highest with fluoxetine and lowest with amitriptyline.ConclusionsMerely prescribing safer-in-overdose antidepressants is unlikely to reduce the overall morbidity from DSH.

scholarly journals Protocol for the assessment of self-harm in young people: initial audit and training implications

2007 ◽  
Vol 31 (6) ◽  
pp. 224-226 ◽  
Author(s):  
Sarah Huline-Dickens ◽  
Tony Adiele
Keyword(s):  
Young People ◽  
Mental State ◽  
Psychosocial Assessment ◽  
Training Requirements ◽  
Junior Staff ◽  
Accident And Emergency ◽  
Self Harm ◽  
Accident And Emergency Department ◽  
State Examination ◽  
And Training

Aims and MethodsThis paper describes the development and initial audit of a protocol for the assessment of young people up to the age of 18 years who presented to the accident and emergency department (A&E) with self-harm. A key part of the project was education and training.ResultsRegular training of senior house officers (SHOs) in A&E may have contributed to an increase in young people being admitted to a bed for proper assessment (as per the protocol), but psychosocial assessments undertaken by SHOs in A&E were still only partial, and there was no apparent use of the mental state examination.Clinical ImplicationsChild and adolescent mental health services have an important role to play in liaising with local A&E departments in training of junior staff in psychosocial assessment and the use of the mental state examination. This is especially relevant in the light of the new training requirements of the foundation years.

scholarly journals Self-injury attendances in the accident and emergency department

2003 ◽  
Vol 183 (1) ◽  
pp. 34-39 ◽  
Author(s):  
Judith Horrocks ◽  
Sally Price ◽  
Allan House ◽  
David Owens
Keyword(s):  
Clinical Importance ◽  
Epidemiological Data ◽  
Psychosocial Assessment ◽  
Self Injury ◽  
After Care ◽  
Accident And Emergency ◽  
History Of ◽  
Self Harm ◽  
Accident And Emergency Department

BackgroundSelf-injury is a neglected area of self-harm research and we know little about its epidemiology, hospital care and outcome.AimsTo provide epidemiological data on self-injury and compare hospital management of self-injury with that for self-poisoning.MethodData were collected on all self-harm attendances to the general hospitals in Leeds over an 18-month period.ResultsPeople attending hospital for self-injury or self-poisoning do not form mutually exclusive groups. There were higher proportions of self-injury episodes compared with self-poisoning, where a history of self-harm or contact with mental health services had been recorded. Fewer psychosocial assessments were carried out after episodes of self-injury compared with self-poisoning but, when they were, follow-up was recommended more often.ConclusionsThe clinical importance of self-injury is not mirrored by the level of psychosocial assessment and after-care provided.

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