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Summary of Results

Health Topic:   Mental health and behavioural conditions
Guidance:   Self-harm
Description:   The summary of the published clinical guideline on Self-harm. It links to the published guidance and key documents.

NICE implementation uptake reports

Implementation uptake report Assessment Published Date Coverage

External literature

External literature Assessment Coverage

Cooper J et al (2008) Communication between secondary and primary care following self-harm: are National Institute of Clinical Excellence (NICE) guidelines being met? Annals of General Psychitry 7

Description: An audit of 93 consecutive episodes of self harm presenting to an Emergency Department. 62% of episodes were communicated to primary care, 58% of these communications were within 24 hours and most within 3 days. Patient identifying details and follow-up arrangements were specified in most cases.

Doubts about or mixed impact in practice Local

Jones R & Avies-Jones A (2007) An audit of the NICE self-harm guidelines at a local accident and emergency department in North Wales Accident and Emergency Nursing 15 pp. 217-222

Description: An audit of 50 consecutive self-harm attendances. Results demonstrate generally high standards of care on psychosocial assessment though information relating to ambulance involvement in treatment was often unclear. 82% of staff had received some training and 47% had received training in the NICE guidelines

Doubts about or mixed impact in practice Local

Royal College of Psychiatrists (2010) Self-harm, suicide and risk: helping people who self harm

Description: The college conducted a survey of 9750 College Members in the UK, 1540 College Members responded, a 16% response rate. Two-thirds of respondents reported having read the NICE guideline. Psychiatrists rated the performance of the service settings in which they work in accordance with six aspects of service provision as specified by NICE. Across all six items, most considered that performance was good or very good; the lowest rated performance was information provision, 67% rated it this way.

Doubts about or mixed impact in practice National

The Centre for Suicide Prevention, Department of Psychiatry. University of Manchester (2009) Self-Harm in Manchester 1st September 2005 to 31st August 2007

Description: Management of self-harm in the emergency department (ED) was known for 5370 (90%) of the 5993 treated episodes of self-harm. Of the episodes treated in the ED: 58% were admitted to a medical bed. Of those that were admitted to a medical bed, 54% received a psychosocial assessment by a mental health specialist.

Doubts about or mixed impact in practice Regional

Ugoh E et al (2010) Management of self-harming patients in a psychiatric ward Journal of Clinical Audits Vol 2(3);p53-59

Description: Data was collected retrospectively from the Hertfordshire Partnership Trust computerised care notes for 3 months between 08/09/2008 to 08/12/2008. Questionnaires were given to service users on admission to Aston ward and at the same time to staff. Results found that 14/14 nurses stated that they were respectful to service users. 9 of the nurses had in-house training but non had formal training. 40% of the service users were not happy with the quality of information about treatment options.

Practice appears not to be in line with guidance Local

Rippon, V. et al (2012) Does the assessment of young people attending hospital with self harm meet national standards? Arch Dis Child 2012 97: A77-A78

Description: Results are presented from a multi-centre retrospective case note audit to determine whether young people who self harm are being assessed according to guidance. Data was collected on a random sample of 160 young people presenting during Jan -Jul 2010 with self harm to a District General and tertiary Children?s Hospital in Nottingham. Results found documentation of adolescent psychosocial factors were rarely recorded and 35% did not have a past medical or social history recorded.

Practice appears not to be in line with guidance Local

Cooper, J. et al (2013) Are hospital services for self-harm getting better? An observational study examining management, service provision and temporal trends in England BMJ Open 2013;3:e003444

Description: This study described the management 6442 individuals presenting with 7689 episodes of self-harm at 32 hospitals in England during a 3 month audit period between May 2010 and June 2011. Results found that a psychosocial assessment took place in 57% of all presentations and the proportion in which an assessment was conducted varied from 24% to 88% between hospitals. The proportion of episodes in which psychosocial assessment occurred and variation rates were similar to an earlier study in 2001.

Doubts about or mixed impact in practice National

This page was last updated: 01 January 2013

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Selected, reliable information for health and social care in one place

Accessibility | Cymraeg | Freedom of information | Vision Impaired | Contact Us | Glossary | Data protection | Copyright | Disclaimer | Terms and conditions

Copyright 2014 National Institute for Health and Care Excellence. All rights reserved.