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 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.

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.

A Study of the Relationship between the Patterns of Planned Activity and Incidents of Deliberate Self-Harm within a Regional Secure Unit

1996 ◽  
Vol 59 (4) ◽  
pp. 156-160 ◽  
Author(s):  
Ruth Garner ◽  
Graham Butler ◽  
Deborah Hutchings
Keyword(s):  
Primary Reason ◽  
Deliberate Self Harm ◽  
Problem Resolution ◽  
Client Group ◽  
System A ◽  
Number Of Patients ◽  
Self Harm ◽  
Secure Unit ◽  
The Relationship ◽  
Reason For Admission

Within a 77-bed Regional Secure Unit, there has been an increase in the number of patients admitted who deliberately do themselves harm, although this Is generally not the primary reason for admission. During this 9-month study, 307 incidents of self-harm were recorded on the clinic's information system; a subgroup of seven patients was responsible for 77.5% of these incidents. Whilst there is a perception among rehabilitation staff that activity has a role in reducing the incidence of deliberate self-harm, this study Identifies no correlation between the patterns of structured activity and the patterns of deliberate self-harm. This does not suggest, however, that occupational therapy is ineffective with this client group, particularly given the potentially addictive nature of deliberate self-harm behaviour even after problem resolution. The study identifies areas for further research, focusing on qualitative rather than quantitative study.

scholarly journals Increasing psychosocial assessment by introducing a self-harm pathway

2006 ◽  
Vol 30 (5) ◽  
pp. 169-172 ◽  
Author(s):  
Peter Lepping ◽  
Barbara Woodworth ◽  
Lucy Roberts ◽  
Jim Turner
Keyword(s):  
Emergency Department ◽  
The Self ◽  
Psychosocial Assessment ◽  
Clinical Implications ◽  
Protocol Adherence ◽  
Steering Group ◽  
Accident And Emergency ◽  
Before And After ◽  
Self Harm ◽  
Accident And Emergency Department

Aims and MethodTo audit whether the introduction of a self-harm pathway and protocol increases the number of psychosocial assessments. All episodes of self-harm in a defined period during 2002 (n=335) and 2004 (n=390) were reviewed before and after the introduction of a self-harm pathway and protocol. Adherence to the protocol was also investigated.ResultsAfter the introduction of the self-harm pathway and protocol, the proportion of psychosocial assessments requested had risen from 57% (2002) to 85% (2004). The proportion of psychosocial assessments completed had risen from 47% to 70%. Over the 2 years, the overall number of self-harm presentations was reduced by 27%.Clinical ImplicationsThe introduction of a self-harm pathway and protocol through a self-harm steering group is feasible, was well accepted and increased the number of psychosocial assessments after self-harm. It may also contribute to a reduction in the number of overall presentations with self-harm to the accident and emergency department.

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

scholarly journals Deliberate self-harm and antidepressant drugs

2000 ◽  
Vol 177 (6) ◽  
pp. 551-556 ◽  
Author(s):  
Stuart Donovan ◽  
Andrew Clayton ◽  
Min Beeharry ◽  
Sheron Jones ◽  
Chris Kirk ◽  
...  
Keyword(s):  
Emergency Department ◽  
Prospective Study ◽  
Serotonin Reuptake ◽  
Antidepressant Drugs ◽  
Tricyclic Antidepressant ◽  
Deliberate Self Harm ◽  
Accident And Emergency ◽  
Self Harm ◽  
Accident And Emergency Department ◽  
A Prospective Study

BackgroundIt is not clear if the frequency of deliberate self-harm (DSH) is the same in patients taking different pharmacological classes of antidepressant drugs.AimsTo compare the frequency of DSH in patients who had been prescribed a tricyclic antidepressant (TCA) or a selective serotonin reuptake inhibitor (SSRI) prior to the DSH event.MethodThis was a prospective study in 2776 consecutive DSH cases attending an accident and emergency department. The incidence of DSH in TCA-treated cases and SSRI-treated cases is expressed as number of DSH events per 10 000 prescriptions of each antidepressant.ResultsSignificantly more DSH events occurred following the prescription of an SSRI than that of a TCA (P < 0.001). The occurrence of DSH was highest with fluoxetine and lowest with amitriptyline.ConclusionsMerely prescribing safer-in-overdose antidepressants is unlikely to reduce the overall morbidity from DSH.

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