scholarly journals Emergency and liaison psychiatry

1990 ◽  
Vol 14 (9) ◽  
pp. 548-549
Author(s):  
Alison Gourdie ◽  
Vivienne Schnieden
Keyword(s):  
Psychiatric Service ◽  
Psychiatric Services ◽  
Liaison Psychiatry ◽  
College Hospital ◽  
Deliberate Self Harm ◽  
Accident And Emergency ◽  
University College ◽  
Self Harm ◽  
Psychiatric Staff

The post of Emergency and Liaison Registrar in the Bloomsbury Rotation was created in 1988 to provide a psychiatric service at University College Hospital, London, in the Accident and Emergency (A&E) Department and to the A&E Ward for assessment of deliberate self harm (DSH) cases. It incorporated existing commitments of liaison to the UCH wards and provision of urgent psychiatric assessments. The service had previously been shared among a number of psychiatric staff. The registrar can thus be seen as a ‘central pivot’ within the District Psychiatric Services.

scholarly journals Liaison psychiatry in detection and management of mental illness

1996 ◽  
Vol 20 (8) ◽  
pp. 466-469
Author(s):  
Margaret Semple ◽  
David Brown ◽  
Elizabeth Irvine
Keyword(s):  
Mental Illness ◽  
Mental Disorder ◽  
Alcohol Misuse ◽  
Psychiatric Service ◽  
Psychiatric Ward ◽  
Liaison Psychiatry ◽  
Deliberate Self Harm ◽  
General Psychiatry ◽  
Self Harm

Of 299 referrals to the Dundee general psychiatry liaison service over a six month period, deliberate self-harm (DSH) was the reason in 83%. An overdose was used in 94%, and alcohol misuse occurred in 56% of DSH episodes. Fifty-two per cent of referrals were followed up by the general psychiatry service; 31% of these were admitted directly to a psychiatric ward, 10% on a compulsory basis. At follow-up, 23% remained in contact with the Dundee psychiatric service. Twenty-three per cent of all patients referred to the Area Alcohol Service (AAS) were in contact with it six months later. Clearly, liaison psychiatry has a role in detection and management of significant mental disorder.

scholarly journals How Many Beds? A survey of needs for treatment and care in an in-patient unit

1988 ◽  
Vol 12 (3) ◽  
pp. 91-94 ◽  
Author(s):  
Frank Holloway ◽  
Gaius Davies ◽  
Marisa Silverman ◽  
Tony Wainwright
Keyword(s):  
Psychiatric Service ◽  
District General Hospital ◽  
Psychiatric Services ◽  
College Hospital ◽  
Local Service ◽  
The Past ◽  
King's College ◽  
Large Institution ◽  
Psychological Medicine ◽  
Slow Progress

Over the past 20 years the Department of Psychological Medicine at King's College Hospital has gradually taken responsibility for the provision of psychiatric services to the East Lambeth sector of the Camberwell Health District. A small District General Hospital (DGH) in-patient unit was opened in 1972, and since then it has been the aim of the Department to provide a comprehensive locally based psychiatric service. Slow progress has been made compared with the developments that have taken place in the South Southwark sector of the District, which have been fostered by the Maudsley Hospital. With the impending closure of Cane Hill Hospital, on which the District has historically relied, the object of a completely local service is rapidly becoming a reality. Releasing the resources hitherto tied to the large institution presents an unparallelled opportunity for change.

Suicide and Parasuicide in Childhood and Early Adolescence

1985 ◽  
Vol 146 (5) ◽  
pp. 459-463 ◽  
Author(s):  
Donald J. Brooksbank
Keyword(s):  
Early Adolescence ◽  
Attempted Suicide ◽  
Psychiatric Services ◽  
Age Group ◽  
Deliberate Self Harm ◽  
England And Wales ◽  
The Social ◽  
Self Harm ◽  
Age Range

Suicide is intentional self-killing, and parasuicide an act of deliberate self-harm—either by injury, ingestion or inhalation—not resulting in death (Blacket al,1982). Both are rare under the age of 12 and the rate of suicide in those under 16 remains consistently low. Referrals to psychiatric services reported by Shaffer (1974) indicated that 7–10% were for threatened or attempted suicide, while Hawton (1982) quoted studies giving the incidence as 10–33% for children aged six to 12; in England and Wales (1962–1968), suicide accounted for 0.6% of deaths in the 10–14 age-range. McClure (1984) found that between 1975 and 1980, only ten such deaths were recorded in the 13-and-under range, and 26 deaths in the 14 year-olds, after which the number of suicides rose sharply with each successive year. That study also showed that parasuicide was most common in the 15–24 age-group, but at younger ages there was a higher proportion of undetermined deaths, as against officially recorded suicides. The social taboos associated with suicide may lead to its systematic under-reporting, but even allowing for that, the phenomenon is still a rare one under the age of 16.

Concordance of clinical estimation of suicidal intent

2002 ◽  
Vol 19 (3) ◽  
pp. 84-85 ◽  
Author(s):  
Helen S Keeley ◽  
Carmel McAuliffe ◽  
Paul Corcoran ◽  
Ivan J Perry
Keyword(s):  
Multicentre Study ◽  
Suicidal Intent ◽  
Deliberate Self Harm ◽  
Statistical Comparison ◽  
Accident And Emergency ◽  
Psychometric Instruments ◽  
Suicide Intent ◽  
Self Harm ◽  
Clinical Records ◽  
Level Of Agreement

AbstractObjective: The aim of this paper is to assess the level of agreement between clinical estimates of suicidal intent based entirely on information recorded in the Accident and Emergency acute assessment and Beck's Suicide Intent Scale (SIS) scores.Method: As part of the WHO/EURO Multicentre Study of Parasuicide, cases of deliberate self-harm (DSH) in Cork city hospitals were monitored. Over the period 1995-1997, the information recorded in the Accident and Emergency acute assessment was examined by a psychiatrist and, if possible on the available evidence, clinical estimates were made at three levels of suicidal intent: minimal, moderate and definite. Seventy-nine of these cases had fully completed Beck's SIS. Statistical comparison was made between the results of the SIS and the clinical estimate of suicide intent.Results: The agreement (Kappa = 0.146, p = 0.046) and concordance (Lin's concordance coefficient = 0.330, p = 0.001) between the two ratings are statistically significant but both are low. The overlap between those identified as high or low intent is low.Conclusions: These findings indicate low agreement between a clinician's rating of suicide intent based on clinical records and Beck's SIS. This is especially relevant given the increasing reliance on psychometric instruments in assessment in psychiatry. However, further investigation is necessary to clarify which is the more valid method.

scholarly journals Effects of education on attitudes to deliberate self-harm

1997 ◽  
Vol 21 (6) ◽  
pp. 334-335 ◽  
Author(s):  
Gill Turnbull ◽  
Trudie Chalder
Keyword(s):  
General Knowledge ◽  
Attitude Questionnaire ◽  
Specialist Service ◽  
Deliberate Self Harm ◽  
Accident And Emergency ◽  
Number Of Patients ◽  
Before And After ◽  
Teaching Package ◽  
Self Harm ◽  
Knowledge And Attitude

Accident and emergency (A&E) staff completed a general knowledge and attitude questionnaire related to suicide and deliberate self-harm (DSH) before and after a teaching package. The results showed an increase in general knowledge while attitudes remained the same. Following the teaching package there was an increase in the number of patients who contacted the Specialist Service for DSH.

Secondary Prevention of Non-fatal Deliberate Self-harm

1993 ◽  
Vol 163 (1) ◽  
pp. 111-112 ◽  
Author(s):  
H. G. Morgan ◽  
E. M. Jones ◽  
J. H. Owen
Keyword(s):  
British Journal ◽  
Early Stage ◽  
Psychiatric Services ◽  
Easy Access ◽  
Deliberate Self Harm ◽  
Self Harm ◽  
One Year ◽  
First Time ◽  
Experimental Group

In an attempt to address the low compliance with offers of treatment shown by patients after episodes of non-fatal deliberate self-harm (DSH), patients who had harmed themselves for the first time were offered rapid, easy access to on-call trainee psychiatrists in the event of further difficulties, and they were encouraged to seek help at an early stage should such problems arise. The follow-up data obtained after one year showed a significant reduction of actual or seriously threatened DSH in the experimental group, who also made considerably less demands on medical and psychiatric services, when compared with controls.British Journal of Psychiatry (1993), 163, 111–112

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 Study on Deliberate Self Harm in a Tertiary Hospital

1970 ◽  
Vol 21 (2) ◽  
pp. 160-165
Author(s):  
AA Mamun Hussain ◽  
ARM Saifuddin Ekram ◽  
MA Alim ◽  
MA Ahad ◽  
S Qais ◽  
...  
Keyword(s):  
Fatal Outcome ◽  
Adjustment Disorder ◽  
Tertiary Hospital ◽  
Comprehensive Treatment ◽  
Self Medication ◽  
College Hospital ◽  
Cross Sectional ◽  
Deliberate Self Harm ◽  
Medical College ◽  
Self Harm

The term ‘Deliberate Self Harm' (DSH) is often used to describe behaviors through which people inflict acute harm upon themselves with non-fatal outcome, when the behaviors are somewhat linked to, but do not result in death. This cross-sectional retrospective study included 66 subjects admitted with DSH in the Department of Medicine of Rajshahi Medical College Hospital during the period of January 2006 to July 2006. Among the respondents 57.57% were female and 42.42% were male, when they were mostly Muslims (89.39%) and only 10.61% were Hindus. As regards to occupation 46.96% were students, 30.30% were housewives and rest belong to others. 68.01% were in the age of 17-28 years. 50% were uneducated, 24.24% completed SSC and rests were in other classes. 42.42% were married, 45.45% were unmarried and others were either separated or divorced. DSH was mostly preceded by recent quarrel (34.84%), followed by poor interaction with parents (19.69%) and rejection of love (18.18%). The common adopted method of self-harm were ingestion of poisons (59.09%) and different self-medication (30.30%). 93.93% had the first attempt, 4.54% had second attempt and only 1 had the third attempt. The motivations were frustration (59.09%), making other feel guilty (25.75%) and to die (10.60%). Psychiatric diagnosis included relational problem (54.54%), major depressive disorder (34.84%), schizophrenia (4.54%) and adjustment disorder (3.03%). This study, in fact suggests a special need for the assessment of DSH and formulation of a comprehensive treatment approach. doi: 10.3329/taj.v21i2.3798 TAJ 2008; 21(2): 160-165

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