Punch injury self-harm in young people

2016 ◽  
Vol 22 (2) ◽  
pp. 318-325
Author(s):  
Cristal Oxley ◽  
Jane E Roberts ◽  
Sebastian Kraemer ◽  
Giles Armstrong
Keyword(s):  
Mental Health ◽  
Emergency Department ◽  
High Risk ◽  
Young People ◽  
Medical Records ◽  
Substance Misuse ◽  
Total Group ◽  
Effective Interventions ◽  
Male Preponderance ◽  
Self Harm

Punch injuries are a form of self-harm characterised by the intentional act of striking an object with a closed fist. We aimed to describe the characteristics and trends in young people presenting with injuries sustained via the punch mechanism. A comprehensive retrospective review of medical records was completed of all young people aged 10–18 years presenting to our Central London Emergency Department over a 12-month period. A subset of the total group was identified as the punch injury subgroup. A total of 78 punch injury presentations were identified. In this subgroup, the male:female ratio is 4.57:1; 37.18% of presentations were associated with a fracture ( n = 29) and 35.90% ( n = 28) of patients re-presented following another punch injury, as a victim of violence, or by other psychiatric presentation. In conclusion, a male preponderance was observed, with frequent re-presentations, often in high-risk circumstances. An opportunity for screening, including mental health, social and substance misuse, was identified. Further research is needed to enable targeted effective interventions in this group.

Deliberate self-harm in young people: attendance at a paediatric emergency department

2009 ◽  
Vol 26 (3) ◽  
pp. 114-118 ◽  
Author(s):  
Sophia Morgan ◽  
Sinead Byrne ◽  
Carole Boylan ◽  
Stephen McLearie ◽  
Carol Fitzpatrick
Keyword(s):  
Emergency Department ◽  
Young People ◽  
Medical Records ◽  
Risk Group ◽  
High Risk Group ◽  
Deliberate Self Harm ◽  
Paediatric Emergency Department ◽  
Paediatric Emergency ◽  
Appropriate Treatment ◽  
Self Harm

AbstractObjectives: Deliberate self-harm (DSH) is the strongest predictor of suicidal behaviour. This retrospective study reviewed all DSH presentations to our Paediatric Emergency Department between 2002-2006.Method: Using database and medical records we profiled these presentations. Data was coded and statistically analysed.Results: There were 253 DSH attendances. Twenty-four percent were living in care, 15% were under 12 years and 14% presented more than once. Overdoses (61%) were more common than cutting (16%) and 56% had a psychiatric condition.Conclusions: DSH presents an ongoing challenge to child and adolescent mental health services and those working in suicide prevention. Identifying the characteristics of these young people is essential to providing appropriate treatment for this high-risk group.

scholarly journals Treating sleep problems in young people at ultra-high-risk of psychosis: study protocol for a single-blind parallel group randomised controlled feasibility trial (SleepWell)

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e045235
Author(s):  
Felicity Waite ◽  
Thomas Kabir ◽  
Louise Johns ◽  
Jill Mollison ◽  
Apostolos Tsiachristas ◽  
...  
Keyword(s):  
Mental Health ◽  
High Risk ◽  
Young People ◽  
Sleep Problems ◽  
Qualitative Interviews ◽  
Feasibility Trial ◽  
Psychotic Experiences ◽  
Post Intervention ◽  
Ultra High Risk ◽  
Randomised Controlled

BackgroundEffective interventions, targeting key contributory causal factors, are needed to prevent the emergence of severe mental health problems in young people. Insomnia is a common clinical issue that is problematic in its own right but that also leads to the development and persistence of psychotic experiences. The implication is that treating sleep problems may prevent the onset of psychosis. We collected initial case series data with 12 young people at ultra-high-risk of psychosis. Post-intervention, there were improvements in sleep, depression and psychotic experiences. Now we test the feasibility of a randomised controlled trial, with a clinical aim to treat sleep problems and hence reduce depression, psychotic experiences, and prevent transition to psychosis.Methods and analysisA randomised controlled feasibility trial will be conducted. Forty patients aged 14 to 25 years who are at ultra-high-risk of psychosis and have sleep disturbance will be recruited from National Health Service (NHS) mental health services. Participants will be randomised to receive either a novel, targeted, youth-focussed sleep intervention in addition to usual care or usual care alone. Assessor-blinded assessments will be conducted at baseline, 3 months (post-intervention) and 9 months (follow-up). The eight-session psychological intervention will target the key mechanisms which disrupt sleep: circadian rhythm irregularities, low sleep pressure, and hyperarousal. To gain an in-depth understanding of participants’ views on the acceptability of the intervention and study procedures, 16 participants (n=10 intervention, n=6 control) will take part in qualitative interviews. Analyses will focus on feasibility outcomes (recruitment, retention, and treatment uptake rates) and provide initial CI estimates of intervention effects. Thematic analysis of the qualitative interviews will assess the acceptability of the intervention and trial procedures.Ethics and disseminationThe trial has received ethical approval from the NHS Health Research Authority. Findings will be disseminated through peer-reviewed publications, conference presentations, and lay networks.Trial registration numberISRCTN85601537.

scholarly journals The impact of the Emergency Department target upon the discharge decision for people who self-harm

2019 ◽  
Vol 19 (2) ◽  
pp. 89-97
Author(s):  
Michael Brian Haslam ◽  
Emma S. Jones
Keyword(s):  
Mental Health ◽  
Emergency Department ◽  
Wait Time ◽  
Adverse Outcomes ◽  
Patient Journey ◽  
Content Type ◽  
Target Time ◽  
Starting Point ◽  
Self Harm ◽  
The Impact

Purpose The purpose of this paper is to consider the influence of the Emergency Department (ED) target wait time upon the discharge decision in ED, specifically for patients who have self-harmed. Pressures to discharge patients to avoid breaching the 4-h target wait time, potentially increase the risk of adverse responses from clinicians. For the patient who has self-harmed, such interactions may be experienced as invalidating and may result in adverse outcomes. Design/methodology/approach Secondary data analysis was applied to the retrospective referral data of a Mental Health Liaison Team (MHLT), collected over a period of 11 months from a single hospital in the North of England. In total, 734 episodes of care were referred to the team from ED, where the primary presentation was recorded as self-harm. Findings Over half of patients referred to the MHLT from ED having self-harmed were seen after already breaching the target and the potential for a more restrictive outcome reduced. Of those patients seen within 4 h, the potential for a more restrictive treatment option was increased. Practical implications Recommendations to improve the patient journey for those who have self-harmed include mental health triage and treatment in clinical areas outside of the target. Social implications This study challenges the concept of the target as being realistic and attainable for patients who have self-harmed. Originality/value This exploratory study provides a starting point from which to explore the impact of the target time upon discharge decisions and clinical outcomes specifically for those who have self-harmed.

scholarly journals Managing organisational change to improve health services for young people with deliberate self harm behaviour

2001 ◽  
Vol 24 (2) ◽  
pp. 143 ◽  
Author(s):  
Margaret J Tobin ◽  
Adam R Clarke ◽  
Richard Buss ◽  
Stewart L Einfeld ◽  
John Beard ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Factor ◽  
Young People ◽  
Organisational Change ◽  
Change Strategies ◽  
Deliberate Self Harm ◽  
Completed Suicide ◽  
Service Engagement ◽  
Self Harm ◽  
Improve Health

Repeat Deliberate Self Harm is a recognised risk factor for completed suicide and therefore reduction by effective healthservice response represents a valid contribution to suicide prevention. However, only a small fraction of people withdeliberate self harm presentations to general health settings actually reach specialist mental health follow-upappointments. Therefore, even if responses at that point are known to be effective they do not make a significantcontribution to reducing repeat self-harm overall. We describe health system organisational change strategies to improvehealth service engagement for the target group, and present data demonstrating the effectiveness of these strategies.

scholarly journals High-risk sexual behaviour in young people with mental health disorders

2018 ◽  
Vol 13 (4) ◽  
pp. 867-873 ◽  
Author(s):  
Asiel Yair Adan Sanchez ◽  
Elizabeth McMillan ◽  
Amit Bhaduri ◽  
Nancy Pehlivan ◽  
Katherine Monson ◽  
...  
Keyword(s):  
Mental Health ◽  
High Risk ◽  
Young People ◽  
Sexual Behaviour ◽  
Mental Health Disorders ◽  
High Risk Sexual Behaviour ◽  
Health Disorders ◽  
Risk Sexual Behaviour

scholarly journals Severe and enduring mental health problems within an established substance misuse treatment partnership

2014 ◽  
Vol 38 (5) ◽  
pp. 216-219 ◽  
Author(s):  
Kathryn Walsh ◽  
Alex Copello
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Suicide Risk ◽  
Substance Misuse ◽  
Mental Health Problems ◽  
Health Problems ◽  
Clinical Implications ◽  
The Past ◽  
Self Harm ◽  
Effective Service

Aims and methodThe study reports findings of an investigation into the presence of severe and enduring mental health problems within the four statutory and non-statutory teams of an established substance misuse treatment partnership.ResultsOf a total of 772 clients in the four teams surveyed, 69 (8.9%) were identified as having severe and enduring mental health problems and problem substance use in the past 12 months. Alcohol was the most prevalent substance used by this predominantly male group. Different rates were found across the four teams, with higher numbers in the non-statutory teams. The clients displayed significant levels of self-harm and suicide risk and were responsible for 131 acute service contacts over the past 12 months.Clinical implicationsClients with severe and enduring mental health problems engaged with substance misuse services display high levels of complex need. It is important to identify the best and most effective service response to this group.

scholarly journals Establishing a Theory-Based Multi-Level Approach for Primary Prevention of Mental Disorders in Young People

2020 ◽  
Vol 17 (24) ◽  
pp. 9445
Author(s):  
Giuseppina Lo Moro ◽  
Emma Soneson ◽  
Peter B. Jones ◽  
Julieta Galante
Keyword(s):  
Mental Health ◽  
Young People ◽  
Randomised Trial ◽  
Intervention Group ◽  
Stakeholder Involvement ◽  
Population Based ◽  
Health Determinants ◽  
Local Stakeholder ◽  
Effective Interventions ◽  
Multi Level

The increasing prevalence of mental health disorders and psychosocial distress among young people exceeds the capacity of mental health services. Social and systemic factors determine mental health as much as individual factors. To determine how best to address multi-level risk factors, we must first understand the distribution of risk. Previously, we have used psychometric methods applied to two epidemiologically-principled samples of people aged 14–24 to establish a robust, latent common mental distress (CMD) factor of depression and anxiety normally distributed across the population. This was linearly associated with suicidal thoughts and non-suicidal self-harm such that effective interventions to reduce CMD across the whole population could have a greater total benefit than those that focus on the minority with the most severe scores. In a randomised trial of mindfulness interventions in university students (the Mindful Student Study), we demonstrated a population-shift effect whereby the intervention group appeared resilient to a universal stressor. Given these findings, and in light of the COVID-19 pandemic, we argue that population-based interventions to reduce CMD are urgently required. To target all types of mental health determinants, these interventions must be multi-level. Careful design and evaluation, interdisciplinary work, and extensive local stakeholder involvement are crucial for these interventions to be effective.

scholarly journals Trends in mental health, non‐suicidal self‐harm and suicide attempts in 16–24-year old students and non-students in England, 2000–2014

2019 ◽  
Vol 55 (1) ◽  
pp. 125-128 ◽  
Author(s):  
S. McManus ◽  
D. Gunnell
Keyword(s):  
Mental Health ◽  
Young People ◽  
Mental Disorder ◽  
Suicide Attempts ◽  
Common Mental Disorder ◽  
Psychiatric Morbidity ◽  
Female Students ◽  
Self Harm ◽  
Using Data ◽  
Over Time

Abstract There are concerns about high levels of mental ill-health amongst university students, but little is known about the mental health of students compared to non-students over time. Using data on young people (16–24) from three UK National Psychiatric Morbidity Surveys (2000, 2007, and 2014), we found no evidence that the overall prevalence of common mental disorder (CMD), suicide attempts, or non-suicidal self-harm (NSSH) differed between students and non-students, although there was an indication that CMDs rose markedly in female students between 2007 and 2014. A rise in NSSH is apparent in both students and non-students.

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