Mental Health Nurses' Dispositional Decision-Making for People Presenting to the Emergency Department With Deliberate Self-Harm: An Exploratory Study

2014 ◽  
Vol 51 (2) ◽  
pp. 148-153 ◽  
Author(s):  
Grant Phillips ◽  
Marie Frances Gerdtz ◽  
Stephen James Elsom ◽  
Tracey J. Weiland ◽  
David Castle
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Emergency Department ◽  
Exploratory Study ◽  
Mental Health Nurses ◽  
Deliberate Self Harm ◽  
Self Harm

scholarly journals Introducing a nurse-led deliberate self-harm assessment service

2001 ◽  
Vol 25 (6) ◽  
pp. 212-214 ◽  
Author(s):  
Gill Griffin ◽  
Jonathan I. Bisson
Keyword(s):  
Mental Health ◽  
Training Needs ◽  
Clinical Implications ◽  
Junior Doctors ◽  
Mental Health Nurses ◽  
Deliberate Self Harm ◽  
Mental Health Nurse ◽  
Health Nurse ◽  
Nurse Assessment ◽  
Self Harm

Aims and MethodThis study considered patients admitted to hospital following deliberate self-poisoning. The characteristics of the patients and the outcomes of assessments by trainee psychiatrists and a mental health nurse were compared.ResultsThere were no significant differences in the outcome of 68 assessments performed by a trainee psychiatrist and 77 by a mental health nurse. The nurse assessment service was well-received by the poisons unit, a medical ward specialising in overdose treatment, and trainee psychiatrists.Clinical ImplicationsPsychosocial assessments following self-poisoning can be provided by appropriately trained and supervised mental health nurses. The introduction of a nurse-led service should enhance relationships with the local poisons unit and reduce the workload of junior doctors without compromising their training needs.

A case for identifying smoking in presentations to the emergency department with suicidality

2018 ◽  
Vol 26 (2) ◽  
pp. 176-180 ◽  
Author(s):  
Kay Wilhelm ◽  
Tonelle Handley ◽  
Prasuna Reddy
Keyword(s):  
Mental Health ◽  
Emergency Department ◽  
Health Behaviours ◽  
Self Report ◽  
Deliberate Self Harm ◽  
Clinical Assessments ◽  
Point Increase ◽  
Lifestyle Measures ◽  
History Of ◽  
Self Harm

Objectives: The aim of this study was to identify mental health and lifestyle factors predicting smoking among people at high risk of suicidal behaviour. Methods: Participants ( n = 363) completed self-report mental health and lifestyle measures at first appointment in a hospital clinic following presentation to the emergency department for deliberate self-harm or suicidal ideation. Results: The rate of daily smoking in this group, 61.4%, is more than four times the rate observed in the general population. Those with a history of previous deliberate self-harm were twice as likely to be smokers. Each one-point increase in poor health behaviours increased the odds of smoking by 22%. Conclusions: Identifying and managing smoking and related lifestyle behaviours are important considerations in routine clinical assessments.

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 Emergency Department Management of Deliberate Self-harm

2019 ◽  
Vol 76 (6) ◽  
pp. 652 ◽  
Author(s):  
Jeffrey A. Bridge ◽  
Mark Olfson ◽  
Jeffrey M. Caterino ◽  
Sara Wiesel Cullen ◽  
Amaya Diana ◽  
...  
Keyword(s):  
Emergency Department ◽  
Deliberate Self Harm ◽  
Emergency Department Management ◽  
Self Harm ◽  
Department Management

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 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.

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