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.

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 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.

Deliberate self-harm: how feasible are the current guidelines?

1999 ◽  
Vol 16 (2) ◽  
pp. 61-63 ◽  
Author(s):  
Alan Currie ◽  
Richard Blennerhassett
Keyword(s):  
Mental Illness ◽  
Ad Hoc ◽  
Recent Attempt ◽  
Deliberate Self Harm ◽  
Time Period ◽  
After Care ◽  
Number Of Patients ◽  
Self Harm ◽  
Planning Group

AbstractObjectives: To examine the operation of a deliberate self-harm service at a large general hospital with reference to standards outlined by the Royal College of Psychiatrists. To examine the characteristics of referrals and to make recommendations for improvements to the service.Method: Data on referral and assessment characteristics were collected for 96 consecutive referrals over a three month period.Results: The services achieved the college standards in relation to the time period for assessments. Most referrals were made routinely at a predictable time but assessments were conducted on an ad hoc basis. Only a minority of those referred had a mental illness or complex problems. A significant number of patients were discharged from the A&E department without a psychiatric assessment. Assessors underemphasised the role of previous deliberate self-harm and/or the presence of mental illness in forming a judgment on the risk of suicide. After-care arrangements were predominantly medical (general practitioners or psychiatrists) with little multidisciplinary input.Conclusions: The deliberate self-harm service at the hospital could be improved by the establishment of a self-harm services planning group to oversee the delivery of the service throughout the hospital and address the deficits identified. Given the number of referrals seen within the service and the fact that deliberate self-harm is only one element of a comprehensive liaison service, consideration should be given to the establishment of a separate multi-disciplinary liaison team. Once again importance is drawn to the need for all assessors to be aware of the risk factors in relation to the future risk of suicide rather than placing undue emphasis on whether the most recent attempt was planned or impulsive in nature.

Deliberate self-harm in Oxford, 1990–2000: a time of change in patient characteristics

2003 ◽  
Vol 33 (6) ◽  
pp. 987-995 ◽  
Author(s):  
K. HAWTON ◽  
L. HARRISS ◽  
S. HALL ◽  
S. SIMKIN ◽  
E. BALE ◽  
...  
Keyword(s):  
Suicide Prevention ◽  
Attempted Suicide ◽  
Psychiatric Care ◽  
Patient Characteristics ◽  
Future Trends ◽  
Clinical Services ◽  
Hospital Services ◽  
Deliberate Self Harm ◽  
Gender And Age ◽  
Self Harm

Background. Trends in deliberate self-harm (DSH) are important because they have implications for hospital services, may indicate levels of psychopathology in the community and future trends in suicide, and can assist in identification of means of suicide prevention.Method. We have investigated trends in DSH and characteristics of DSH patients between 1990 and 2000 based on data collected through the Oxford Monitoring System for Attempted Suicide.Results. During the 11-year study period 8590 individuals presented following 13858 DSH episodes. The annual numbers of persons and episodes increased overall by 36·3% and 63·1% respectively. Rates (Oxford City) declined, however, in the final 3 years. There were gender- and age-specific changes, with a rise in DSH rates in males aged [ges ]55 years and in females overall and those aged 15–24 years and 35–54 years. Repetition of DSH increased markedly during the study period. Antidepressant overdoses, especially of SSRIs, increased substantially. Paracetamol overdoses declined towards the end of the study period. Alcohol abuse, use of alcohol in association with DSH, and violence increased, especially in females, and the proportion of patients in current psychiatric care and misusing drugs also rose.Conclusions. While overall rates of DSH did not increase markedly between 1990 and 2000, substantial changes in the characteristics of the DSH population and a rise in repetition suggest that the challenges facing clinical services in the management of DSH patients have grown.

A survey of liaison psychiatry services in the south-west of England

2003 ◽  
Vol 27 (3) ◽  
pp. 90-92 ◽  
Author(s):  
Alison Howe ◽  
Julie Hendry ◽  
John Potokar
Keyword(s):  
Mental Health ◽  
Unmet Need ◽  
Postal Survey ◽  
Clinical Implications ◽  
The South ◽  
Liaison Psychiatry ◽  
South West ◽  
Accident And Emergency ◽  
Self Harm ◽  
Clinical Directors

Aims and MethodA postal survey was conducted to establish an overview of liaison psychiatry services in the south-west of England. Questionnaires were sent to all clinical directors of medicine, accident and emergency, and mental health in trusts which provide acute medical services.ResultsThirty-six questionnaires were returned (77%), covering 17 out of 18 trusts providing acute services. Five trusts (28%) have a comprehensive dedicated liaison psychiatry service. A further six trusts (33%) have a service for deliberate self-harm only. Many respondents were critical of what they perceived to be an inadequate service. Five trusts had introduced a service in the 12 months preceding the survey.Clinical ImplicationsAn unmet need for liaison psychiatry services is clearly perceived across the south-west of England.

Assessment following deliberate self-harm: who are we seeing and are we following the guidelines?

2001 ◽  
Vol 18 (4) ◽  
pp. 116-119 ◽  
Author(s):  
MacDara McCauley ◽  
Vincent Russell ◽  
Declan Bedford ◽  
Ashar Khan ◽  
Roisin Kelly
Keyword(s):  
General Hospital ◽  
Demographic Data ◽  
Medical Personnel ◽  
Adjustment Disorder ◽  
Discharge Summary ◽  
Service Planning ◽  
Deliberate Self Harm ◽  
Self Harm ◽  
Alcohol And Drug Abuse ◽  
Planning Group

AbstractObjectives: To determine whether assessments of patients admitted to a general hospital following deliberate self-harm (DSH) were in line with the Royal College of Psychiatrists guidelines. To examine the profile of cases and presentations and to make recommendations for improvements to the service.Method: Clinical and demographic data recorded on 70 admissions after DSH during 1997-98 were analysed retrospectively. A checklist was also developed, using factors shown by previous research to be associated with future risk of suicide, to determine the quality of assessments.Results: The majority (70%) of assessments took place within 24 hours of admission thereby meeting College recommendations. Medical personnel performed all adult assessments. Circumstances of the overdose, recent stresses, psychiatric diagnosis, immediate risk and follow-up arrangements were documented in the majority of cases. Family psychiatric history, past suicidal behaviour, alcohol and drug abuse history, and previous violence, were frequently not documented. A copy of a discharge summary to the GP was found in 41% of charts. Overdoses accounted for 93% of cases of DSH. The most frequently recorded problem (37.5%) was adjustment disorder.Conclusions: Despite evidence showing that non-psychiatric medical staff are competent in assessing DSH and guidelines encouraging multidisciplinary involvement, DSH assessments remain the preserve of the medical psychiatric team. Closer attention should be paid to all the risk factors associated with suicide by assessors; a checklist could prove helpful. There is room for improved communication between psychiatric services and GPs following DSH. The setting up of a self-harm service planning group could improve the co-ordination and efficiency of delivery of general hospital services to this patient group.

Addressing substance misuse in medium secure settings in the UK and Ireland – a survey of current practice

2015 ◽  
Vol 17 (3) ◽  
pp. 192-203 ◽  
Author(s):  
Jeremy Sandbrook ◽  
Tom Clark ◽  
Karen Amanda Cocksedge
Keyword(s):  
Best Practice ◽  
Substance Misuse ◽  
Postal Survey ◽  
Forensic Mental Health ◽  
Content Type ◽  
National Guidance ◽  
Training Unit ◽  
The Uk ◽  
And Training ◽  
Practical Implications

Purpose – Rates of co-morbid substance misuse are high within forensic populations. Addressing these problems should be a priority as mental disorder with co-morbid substance misuse is associated with worse outcomes, including rates of re-offending and violence recidivism. A study undertaken in 2006 by the Royal College of Psychiatrists’ Research and Training Unit concluded that the provision of substance misuse treatments in medium-secure units (MSUs) at that time was inadequate. The purpose of this paper is to investigate how services may have developed since then to inform discussion over future development and best practice. Design/methodology/approach – A postal survey, supported by the Quality Network for Forensic Mental Health Services, was sent to 62 MSUs across the UK and Ireland. This questioned prevalence, interventions and staff training in substance misuse. Findings – In total, 41 units responded (66 per cent). The data suggest rates of substance misuse within MSUs have reduced and provision of treatment has increased in recent years. The majority of MSUs provide a variety of interventions to address substance misuse and are internally resourced, in tune with current national guidance. However, the data suggest many MSU staff are not receiving adequate training in substance misuse treatments and some MSUs do not appear to have a cohesive strategy that would be consistent with best practice. Practical implications – This study provides an up-to-date overview of the provision of treatment for substance misuse within MSUs. Originality/value – There is no other source for this information, which will provide an invaluable reference point for services seeking to develop or improve their clinical services.

scholarly journals A survey of liaison psychiatry services in the south-west of England

2003 ◽  
Vol 27 (03) ◽  
pp. 90-92
Author(s):  
Alison Howe ◽  
Julie Hendry ◽  
John Potokar
Keyword(s):  
Mental Health ◽  
Unmet Need ◽  
Postal Survey ◽  
Clinical Implications ◽  
The South ◽  
Liaison Psychiatry ◽  
South West ◽  
Accident And Emergency ◽  
Self Harm ◽  
Clinical Directors

Aims and Method A postal survey was conducted to establish an overview of liaison psychiatry services in the south-west of England. Questionnaires were sent to all clinical directors of medicine, accident and emergency, and mental health in trusts which provide acute medical services. Results Thirty-six questionnaires were returned (77%), covering 17 out of 18 trusts providing acute services. Five trusts (28%) have a comprehensive dedicated liaison psychiatry service. A further six trusts (33%) have a service for deliberate self-harm only. Many respondents were critical of what they perceived to be an inadequate service. Five trusts had introduced a service in the 12 months preceding the survey. Clinical Implications An unmet need for liaison psychiatry services is clearly perceived across the south-west of England.

Coping Style as a Mediator of the Relationship Between Depressive Symptoms and Deliberate Self-Harm

Crisis ◽  
2011 ◽  
Vol 32 (5) ◽  
pp. 272-279 ◽  
Author(s):  
Allison S. Christian ◽  
Kristen M. McCabe
Keyword(s):  
Depressive Symptoms ◽  
Undergraduate Students ◽  
Cross Sectional Study ◽  
Self Report ◽  
Hierarchical Regression ◽  
Cross Sectional ◽  
Deliberate Self Harm ◽  
Self Blame ◽  
Self Harm ◽  
The Relationship

Background: Deliberate self-harm (DSH) occurs with high frequency among clinical and nonclinical youth populations. Although depression has been consistently linked with the behavior, not all depressed individuals engage in DSH. Aims: The current study examined maladaptive coping strategies (i.e., self-blame, distancing, and self-isolation) as mediators between depression and DSH among undergraduate students. Methods: 202 students from undergraduate psychology courses at a private university in Southern California (77.7% women) completed anonymous self-report measures. Results: A hierarchical regression model found no differences in DSH history across demographic variables. Among coping variables, self-isolation alone was significantly related to DSH. A full meditational model was supported: Depressive symptoms were significantly related to DSH, but adding self-isolation to the model rendered the relationship nonsignificant. Limitations: The cross-sectional study design prevents determination of whether a casual relation exists between self-isolation and DSH, and obscures the direction of that relationship. Conclusions: Results suggest targeting self-isolation as a means of DSH prevention and intervention among nonclinical, youth populations.

Sign in / Sign up

Export Citation Format

Share Document