Contact with Mental Health Services After Acute Care for Self‐Harm Among Adults Released from Prison: A Prospective Data Linkage Study

2020 ◽  
Vol 50 (5) ◽  
pp. 990-1006 ◽  
Author(s):  
Jesse T. Young ◽  
Rohan Borschmann ◽  
Ed Heffernan ◽  
Matthew J. Spittal ◽  
Lisa Brophy ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Acute Care ◽  
Data Linkage ◽  
Linkage Study ◽  
Prospective Data ◽  
Self Harm

scholarly journals Contact with mental health services after medically verified self-harm: A prospective data linkage study

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Jesse Young ◽  
Rohan Borschmann ◽  
Stuart Kinner
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Service Use ◽  
Linkage Study ◽  
Hospital Inpatient ◽  
Self Harm ◽  
Service Contact

IntroductionHigh rates of self-harm resulting in acute health service contact have been observed in adults released from prison. Contact with health services due to self-harm is a key intervention opportunity to prevent deleterious health outcomes. Little is known about subsequent mental health service contact after discharge from acute health services. Objectives and ApproachWe aimed to describe mental health service contact after discharge from acute health service contacts following self-harm in a representative sample of adults released from prison. Ambulance, emergency department (ED), hospital inpatient and ambulatory mental health service records were probabilistically linked to pre-release interview data. Self-harm events after release were identified from ICD codes and coded from case notes in ambulance, ED, and hospital records. We calculated the time between discharge from ambulance, ED, or hospital after self-harm and subsequent contact with mental health services. Factors predicting the likelihood of mental health service contact were examined using multivariate logistic regression. ResultsOf 1307 adults released from prison, 108 (8.3%) experienced 218 self-harm events resulting in acute health service use in the community. Of these presentations, 0%, 59%, and 50% of discharges from ambulance attendances, ED and hospital, respectively, had subsequent contact with a specialist mental health service within 7 days of that acute service contact. Mental health service contact within 7 days of acute service contact was positively associated with being female (adjusted odds ratio [AOR]: 3.27; 95%CI: 1.26-8.47) and being identified by prison staff as at risk for self-harm (AOR: 3.34; 95%CI: 1.29-8.62), and was negatively associated with dual diagnosis (AOR: 0.19: 95%CI: 0.06-0.61), substance use disorder only (AOR: 0.13; 95%CI: 0.04-0.48) and physical health functioning (AOR: 0.96; 95\%CI: 0.92-0.99). Conclusion/ImplicationsAlmost half of adults with a recent history of incarceration discharged from acute health service after self-harm did not receive timely specialist mental health care. Improved integration of acute health services and ambulatory mental health services could improve outcomes for adults who present with self-harm.

scholarly journals Referral pathways between the mental health services and Jigsaw

2018 ◽  
Vol 36 (3) ◽  
pp. 195-199
Author(s):  
E. Beatty ◽  
R. Keogh ◽  
D. Cohen ◽  
G. McDonald ◽  
C. McDonald ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Services ◽  
Health Services ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Mental Health Difficulties ◽  
Self Harm ◽  
Clinical Profiles ◽  
Similarities And Differences

ObjectivesTo examine similarities and differences in the demographic and clinical profiles of young people (15–25 years of age) referred between the mental health services (MHS) and Jigsaw Galway.MethodsA retrospective chart review was conducted of clinical files of individuals attending secondary MHS who had been referred to or from Jigsaw Galway over a 5-year period. Differences in demographic and clinical data between individuals referred to or from Jigsaw Galway were compared.ResultsA recent act of self-harm was more prevalent in individuals referred from Jigsaw to the adult MHS (p=0.02). No other demographic or clinical differences were detected between individuals attending Jigsaw Galway and the MHS.ConclusionsEducation sessions for clinical staff working in primary care, Jigsaw Galway and the MHS are suggested to support clinicians in choosing the best referral pathway, which may more optimally address young people’s mental health difficulties.

scholarly journals Ambulance attendances resulting from self-harm after release from prison: a prospective data linkage study

2017 ◽  
Vol 52 (10) ◽  
pp. 1295-1305 ◽  
Author(s):  
Rohan Borschmann ◽  
Jesse T. Young ◽  
Paul Moran ◽  
Matthew J. Spittal ◽  
Ed Heffernan ◽  
...  
Keyword(s):  
Data Linkage ◽  
Linkage Study ◽  
Prospective Data ◽  
Self Harm ◽  
Release From Prison

scholarly journals Primary care clinical management following self-harm during the first wave of COVID-19 in the UK

2021 ◽  
Author(s):  
Sarah Steeg ◽  
Matthew J Carr ◽  
Laszlo Trefan ◽  
Darren M Ashcroft ◽  
Nav Kapur ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Services ◽  
Health Services ◽  
Psychotropic Medication ◽  
Clinical Management ◽  
Practice Nurse ◽  
Self Harm ◽  
The Uk ◽  
The Impact

AbstractBackgroundA substantial reduction in GP-recorded self-harm occurred during the first wave of COVID-19 but effects on primary care management of self-harm are unknown.AimTo examine the impact of COVID-19 on clinical management within three months of an episode of self-harm.Design and settingProspective cohort study using data from the UK Clinical Practice Research Datalink.MethodWe compared cohorts of patients with an index self-harm episode recorded during a pre-pandemic period (10th March-10th June, 2010-2019) versus the COVID-19 first-wave period (10th March-10th June 2020). Patients were followed up for three months to capture psychotropic medication prescribing, GP/practice nurse consultation and referral to mental health services.Results48,739 episodes of self-harm were recorded during the pre-pandemic period and 4,238 during the first-wave COVID-19 period. Similar proportions were prescribed psychotropic medication within 3 months in the pre-pandemic (54.0%) and COVID-19 first-wave (54.9%) cohorts. Likelihood of having at least one GP/practice nurse consultation was broadly similar (83.2% vs. 80.3% in the COVID-19 cohort). The proportion of patients referred to mental health services in the COVID-19 cohort (3.4%) was around half of that in the pre-pandemic cohort (6.5%).ConclusionDespite the challenges experienced by primary healthcare teams during the initial COVID-19 wave, prescribing and consultation patterns following self-harm were broadly similar to pre-pandemic levels. However, the reduced likelihood of referral to mental health services warrants attention. Accessible outpatient and community services for people who have self-harmed are required as the COVID-19 crisis recedes and the population faces new challenges to mental health.

The management of young people who self-harm by New Zealand Infant, Child and Adolescent Mental Health Services: cutting-edge or cutting corners?

2018 ◽  
Vol 26 (2) ◽  
pp. 152-159
Author(s):  
Hiran Thabrew ◽  
Ernest Gandeza ◽  
Giselle Bahr ◽  
David Bettany ◽  
Chris Bampton ◽  
...  
Keyword(s):  
Mental Health ◽  
New Zealand ◽  
Mental Health Services ◽  
Young People ◽  
Health Services ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
Evidence Based ◽  
Behaviour Therapy ◽  
Self Harm

Objectives: Self-harm is common in New Zealand (NZ) young people and can have short-term and long-term consequences, including suicide. This study was undertaken to examine the extent to which evidence-based approaches for addressing self-harm are offered by Infant, Child and Adolescent Mental Health Services (ICAMHS). Methods: A national survey of ICAMHS practitioners working with young people who self-harm was undertaken between May and July 2016. Results: Responses from 23 out of 30 ICAMHS confirmed self-harm was a familiar presentation and most commonly associated with diagnoses of depression, anxiety and borderline personality disorder. Cognitive behavioural therapy (47.1%, n = 8), dialectical behaviour therapy (47.1%, n = 8) and acceptance and commitment therapy (5.9%, n = 1) were the treatments of choice, but variably delivered. There were significant training gaps for all types of therapy. Conclusions: Although it is reassuring that many ICAMHS are using evidence-based approaches to address self-harm in young people, there is concerning variability in the way these therapies are delivered. Improvement in training in key modalities, further research into therapist performance and continuous evaluation of workforce development are needed to maximise the effectiveness of proven interventions and provide NZ young people with the state-of-the-art service they deserve.

scholarly journals Characterizing individuals accessing mental health services in the UAE: a focus on youth living in Dubai

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Mariapaola Barbato ◽  
Shaikha Al Hemeiri ◽  
Shorouk Nafie ◽  
Baraa A. Dhuhair ◽  
Nadia T. Dabbagh
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Child Psychiatry ◽  
Help Seeking ◽  
Depressive Disorders ◽  
Treatment Seeking ◽  
Pathways To Care ◽  
Self Harm ◽  
Psychotic Features

Abstract Background Most mental health issues develop during adolescence, therefore identifying youth mental health needs and pathways to care is critical to improve prevention. To date, studies have typically focused on Western samples, while the impact of cultural diversity on perception of health and illness, and pathways to care, remain poorly understood. To address the shortage of studies conducted in the Arab world, and particularly in the United Arab Emirates (UAE), the present investigation aims to identify the characteristics of youth accessing mental health services in Dubai. Methods Data was collected retrospectively from patients’ records at Rashid Hospital Child Psychiatry Service. Information collected included demographics, life stressors, symptoms duration, main diagnosis, and presence/absence of psychotic features in patients’ symptomatology. The relationship between demographic and clinical variables was explored using Chi-square tests and negative binomial regression models. Results The sample included 99 treatment-seeking young patients (mean age 15.3; SD = 1.7); 47.5 % were Emirati (UAE national) and 52.5 % were non-Emirati patients. In our treatment-seeking youth sample Depressive disorders represented the most frequent diagnosis, followed by Bipolar and related disorders, Anxiety and stress related disorders, and Schizophrenia and psychotic disorders. Compared to Emirati patients, non-Emirati patients were more likely to report relationships with friends as a source of stress. Female help-seekers, compared to males, were more likely to report stressful relationships with family members, and to receive a diagnosis of Depressive disorders. The duration of symptoms before seeking help was significantly predicted by family stress, gender, self-harm behavior, a symptomatology with psychotic features, and a diagnosis of Anxiety disorders. Conclusions The present study contributes to characterizing youth accessing mental health services at Rashid Hospital’s Child Psychiatry service in Dubai. An overall prevalence of poor family functioning among help-seeking youth, and the importance of peer support for expatriate youth were highlighted. Gender differences in perceived stressors, diagnoses and help-seeking behavior suggest the need to promote help-seeking among young boys. While presentation with psychotic features seems to lead to quicker access to medical care, self-harm and anxiety appear to delay help-seeking. The potential implications of our results for promoting youth wellbeing in the region are discussed.

scholarly journals Prevalence and Correlates of Suicidal Ideation and Deliberate Self-harm in Canadian Adolescents During the Coronavirus Disease 2019 Pandemic

2021 ◽  
pp. 070674372110366
Author(s):  
Brianna J. Turner ◽  
Christina L. Robillard ◽  
Megan E. Ames ◽  
Stephanie G. Craig
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Suicidal Ideation ◽  
Mental Health Services ◽  
Health Services ◽  
Online Survey ◽  
Warning Signs ◽  
Deliberate Self Harm ◽  
Health Concerns ◽  
Self Harm

Objective In light of recent evidence that the coronavirus disease 2019 (COVID-19) pandemic has resulted in marked increases in depression, anxiety, substance use, and other mental health concerns among Canadian adolescents, we investigated the rates of self-harm thoughts and behaviours in this population. Specifically, this study explored: (1) the demographic and geographic distributions of suicidal ideation (SI) and deliberate self-harm (DSH), and (2) the associations of mental health and substance use with SI and DSH. Method A total of 809 Canadian adolescents, aged 12–18 years, completed an online survey between June 17, 2020 and July 31, 2020. Results 44% of adolescents reported experiencing SI since the pandemic began, while 32% reported engaging in DSH. SI and DSH were more common among youth who: identified as transgender, non-binary or gender fluid; who did not reside with both parents; and who reported psychiatric concerns or frequent cannabis use. Conclusion Canadian adolescents appear to be experiencing higher rates of self-harm thoughts and behaviours relative to before the COVID-19 pandemic. It is important for adults who are likely to interact with distressed youth to be aware of potential warning signs that a youth is struggling with self-harm, and to refer youth to specialty mental health services where appropriate.

scholarly journals Predicting self-harm within six months after initial presentation to youth mental health services: A machine learning study

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243467
Author(s):  
Frank Iorfino ◽  
Nicholas Ho ◽  
Joanne S. Carpenter ◽  
Shane P. Cross ◽  
Tracey A. Davenport ◽  
...  
Keyword(s):  
Mental Health ◽  
Machine Learning ◽  
Mental Health Services ◽  
Young People ◽  
Health Services ◽  
Prediction Models ◽  
Youth Mental Health ◽  
Net Benefit ◽  
History Of ◽  
Self Harm

Background A priority for health services is to reduce self-harm in young people. Predicting self-harm is challenging due to their rarity and complexity, however this does not preclude the utility of prediction models to improve decision-making regarding a service response in terms of more detailed assessments and/or intervention. The aim of this study was to predict self-harm within six-months after initial presentation. Method The study included 1962 young people (12–30 years) presenting to youth mental health services in Australia. Six machine learning algorithms were trained and tested with ten repeats of ten-fold cross-validation. The net benefit of these models were evaluated using decision curve analysis. Results Out of 1962 young people, 320 (16%) engaged in self-harm in the six months after first assessment and 1642 (84%) did not. The top 25% of young people as ranked by mean predicted probability accounted for 51.6% - 56.2% of all who engaged in self-harm. By the top 50%, this increased to 82.1%-84.4%. Models demonstrated fair overall prediction (AUROCs; 0.744–0.755) and calibration which indicates that predicted probabilities were close to the true probabilities (brier scores; 0.185–0.196). The net benefit of these models were positive and superior to the ‘treat everyone’ strategy. The strongest predictors were (in ranked order); a history of self-harm, age, social and occupational functioning, sex, bipolar disorder, psychosis-like experiences, treatment with antipsychotics, and a history of suicide ideation. Conclusion Prediction models for self-harm may have utility to identify a large sub population who would benefit from further assessment and targeted (low intensity) interventions. Such models could enhance health service approaches to identify and reduce self-harm, a considerable source of distress, morbidity, ongoing health care utilisation and mortality.

Ligature Points and Ligature Types Used by Psychiatric Inpatients Who Die by Hanging

Crisis ◽  
2012 ◽  
Vol 33 (2) ◽  
pp. 87-94 ◽  
Author(s):  
Isabelle M. Hunt ◽  
Kirsten Windfuhr ◽  
Jenny Shaw ◽  
Louis Appleby ◽  
Nav Kapur
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Patient Characteristics ◽  
Drug Misuse ◽  
Self Harm ◽  
Trends Over Time ◽  
Clinical Survey ◽  
Over Time ◽  
Do So

Background: Approximately three-quarters of patients who die by suicide on psychiatric wards do so by hanging/strangulation. Increased awareness of the methods used by these patients may benefit prevention strategies in mental health services. Aims: To describe the ligature points and ligatures used in ward hangings; to identify any trends over time in ligature points and ligatures used; and to compare these patient characteristics with other inpatient suicides. Methods: A national clinical survey of suicide cases in recent (< 1 year) contact with mental health services in England and Wales (1999–2007). Results: Of the 448 suicides that occured on psychiatric wards, 77% were by hanging. The number of hanging cases, however, has fallen by 74% since 1999. The most common ligature points and ligatures were doors, hooks/handles, windows, and belts or sheets/towels, respectively. Use of shoelaces, doors, and windows increased over time. These patient suicides had had high rates of self-harm, alcohol/drug misuse, and were more likely than other cases to have died early in admission and been formally detained for treatment. Conclusions: Despite the decrease in inpatient suicides by hanging, regular reviews of ward structures are needed, particularly as ligatures and ligature points change over time. Improving the ward environment to engage patients, especially early in admission, may also contribute to reducing risk.

Sign in / Sign up

Export Citation Format

Share Document