scholarly journals General hospital services for those who carry out deliberate self-harm

1998 ◽  
Vol 22 (2) ◽  
pp. 88-91 ◽  
Author(s):  
Tom Hughes ◽  
Susan Hampshaw ◽  
Edward Renvoize ◽  
David Storer
Keyword(s):  
Implementation Strategy ◽  
Emergency Service ◽  
Structured Interview ◽  
Hospital Services ◽  
National Guidelines ◽  
Specialist Service ◽  
Deliberate Self Harm ◽  
Department Of Health ◽  
Accident And Emergency ◽  
Self Harm

The Royal College of Psychiatrists has published national guidelines for services for those who carry out deliberate self-harm. This study aimed to discover whether these recommendations are being followed. We conducted a semi-structured interview with a professional from the accident and emergency service and one from the specialist service at each of 16 hospitals in the former Yorkshire Regional Health Authority. The findings are that services are not adhering to the guidelines. The production of guidelines without an adequate implementation strategy is ineffective. The Department of Health should endorse the College guidelines, and produce an implementation strategy to secure the involvement of purchasers and providers.

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.

scholarly journals A national survey of the hospital services for the management of adult deliberate self-harm

2001 ◽  
Vol 25 (2) ◽  
pp. 53-55 ◽  
Author(s):  
Rebecca Slinn ◽  
Amanda King ◽  
Jonathan Evans
Keyword(s):  
Postal Survey ◽  
Hospital Services ◽  
National Guidelines ◽  
Deliberate Self Harm ◽  
National Guidance ◽  
Adult Psychiatry ◽  
Self Harm ◽  
Planning Group ◽  
Clinical Directors ◽  
And Training

Aims and MethodServices were compared for the management of deliberate self-harm with existing national guidance. A postal survey was sent to all clinical directors of adult psychiatry at all NHS trusts assessing adult patients admitted to general hospital following deliberate self-harm in England.ResultsResponses were received from 129 (65%) trusts.Thirty per cent of trusts do not use secondary psychiatric services for psycho-social assessment following deliberate self-harm; 52% have designated self-harm liaison staff and 69% of general hospitals have a ward to which most cases of deliberate selfharm are admitted. However, only 18% have staff with psychiatric experience. In 82% of trusts training is provided for junior psychiatrists at induction but in only 56% are observed-assessments undertaken. Forty-two per cent of the trusts have a deliberate self-harm services planning group.Clinical ImplicationsStandards for deliberate self-harm services fall substantially below existing national guidelines, particularly in the areas of planning and training.

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 Training and supervision of deliberate self-harm assessments

1998 ◽  
Vol 22 (8) ◽  
pp. 510-512 ◽  
Author(s):  
Simon Taylor
Keyword(s):  
One Health ◽  
Consensus Statement ◽  
Postal Questionnaire ◽  
Health Departments ◽  
National Guidelines ◽  
Training Experience ◽  
Management Options ◽  
Deliberate Self Harm ◽  
Training And Supervision ◽  
Self Harm

Over a decade has now elapsed since the last national guidelines from Government health departments about the management of deliberate self-harm, although the scale of the problem has remained unchanged. Three years ago the Royal College of Psychiatrists issued a consensus statement which set standards for suitability of staff, particularly with regard to training, experience and supervision, the available facilities for assessment, the range of appropriate management options, communication of these and management of services. This postal questionnaire study in one health region of England of all senior house officers and registrars working in psychiatry found that levels of training and supervision varied widely and often fell below those suggested.

scholarly journals Assessment of deliberate self-harm on medical wards

1992 ◽  
Vol 16 (5) ◽  
pp. 262-263 ◽  
Author(s):  
C. V. R. Blacker ◽  
R. Jenkins ◽  
T. Silverstone
Keyword(s):  
Social Security ◽  
Royal College ◽  
Working Party ◽  
Medical Team ◽  
Deliberate Self Harm ◽  
Department Of Health ◽  
Self Harm ◽  
Medical Wards ◽  
New Guidelines

In 1984, the Department of Health and Social Security issued guidelines, based upon the recommendations of a working party of the Royal College of Psychiatrists, on the management of patients admitted to hospital following acts of deliberate self-harm (DSH). Unlike the 1968 Hill report (which recommended that all such patients should be assessed by a psychiatrist before discharge) the new guidelines placed the responsibility for psychosocial assessments on the admitting medical team.

Deliberate self-harm: a comparison of first-time cases and cases with a prior history

1995 ◽  
Vol 12 (4) ◽  
pp. 131-134 ◽  
Author(s):  
Kamal Gupta ◽  
Kandiah Sivakumar ◽  
Nigel Smeeton
Keyword(s):  
Physical Violence ◽  
Previous History ◽  
Structured Interview ◽  
Entire Group ◽  
Prior History ◽  
Deliberate Self Harm ◽  
Suicide Intent ◽  
Self Harm ◽  
Death Wishes ◽  
First Time

AbstractObjective: Eighty one patients admitted following deliberate self-harm were assessed using a semi-structured interview. The aim of the study was to compare clinical and social profiles of the 42 patients who had committed self harm for the first time with those of the 39 who had committed self harm in the past.Method: The patients were assessed jointly by a psychiatrist and either a community psychiatric nurse or a social worker. A description of past suicidal behaviour, socio demographic information, medical and psychiatric history were recorded. Suicide intent was assessed both from the clinical interview and rated objectively using Pierce's suicide intent scale. Psychiatric diagnoses were made using the ICD 9 classification.Results: The entire group had experienced difficulties in sustaining relationships. This problem was significantly more widespread in repeaters with increased use of physical violence in their relationship. More patients with a previous history claimed to have death wishes at the time of self harm, and asserted that they would harm themselves again compared with patients without a previous history. Clinical predictions regarding future self harming behaviour were in line with the patient's stated intentions.Conclusion: The persistent desire to commit self harm and more widespread relational difficulties amongst the patients with a previous history suggests a need for different treatment strategies and outcome measures for the two groups.

scholarly journals Managing patients with deliberate self harm who refuse treatment in accident and emergency departments

BMJ ◽  
1999 ◽  
Vol 319 (7214) ◽  
pp. 916-916 ◽  
Author(s):  
A. Hull ◽  
F. Haut ◽  
E. Feldman ◽  
W. Bingley ◽  
T. Hassan ◽  
...  
Keyword(s):  
Emergency Departments ◽  
Deliberate Self Harm ◽  
Accident And Emergency ◽  
Self Harm
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