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Self-harm: the short-term physical and psychological management and secondary prevention of self-harm in primary and secondary care [CG16]

Measuring the use of this guidance

Recommendation: 1.4.1.1

When an individual presents in the emergency department following an episode of self-harm, emergency department staff responsible for triage should urgently establish the likely physical risk, and the person's emotional and mental state, in an atmosphere of respect and understanding.

What was measured: Proportion of patients who present to the Emergency Department who have self-harmed and were asked specifically about all of the following: suicidal intent and act, safeguarding, concerns, assessing risk of repetition, assessing risk of potential harm to others.
Data collection end: December 2014
36%
Area covered: UK
Source: Royal College of Emergency Medicine. Mental Health in the ED

What was measured: Proportion of patients who present to the Emergency Department who have self-harmed and have a risk-assessment documented in their notes.
Data collection end: December 2014
68%
Area covered: UK
Source: Royal College of Emergency Medicine. Mental Health in the ED


Recommendation: 1.4.1.5

All people who have self-harmed should be offered a preliminary psychosocial assessment at triage (or at the initial assessment in primary or community settings) following an act of self-harm. Assessment should determine a person's mental capacity, their willingness to remain for further (psychosocial) assessment, their level of distress and the possible presence of mental illness.

What was measured: Patients who had a psychosocial assessment undertaken by mental health specialist
Data collection end: June 2011
57%
Number that met the criteria: / 7689
Area covered: National
Source: 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; Vol 3, e003444 doi:10.1136/bmjopen-2013-003444

What was measured: Proportion of patients with documented evidence that the triage assessment includes level of distress.
Data collection end: December 2012
22%
Number that met the criteria: 11 / 50
Data collection end: December 2013
64%
Area covered: Local
Source: Cracknell, B. (2015) Improving the quality of initial management of self harm and suicide patients in A & E at the James Paget Hospital. BMJ Quality Improvement Reports. Volume 4 (1)

What was measured: Proportion of patients who received a full assessment of social and psychological needs.
Data collection end: December 2012
14%
Number that met the criteria: 7 / 50
Data collection end: December 2013
42%
Data collection end: December 2014
46%
Area covered: Local
Source: Cracknell, B. (2015) Improving the quality of initial management of self harm and suicide patients in A & E at the James Paget Hospital. BMJ Quality Improvement Reports. Volume 4 (1)

What was measured: Proportion of patients with documented evidence that the triage assessment includes capacity and and willingness to accept treatment.
Data collection end: December 2013
70%
Area covered: Local
Source: Cracknell, B. (2015) Improving the quality of initial management of self harm and suicide patients in A & E at the James Paget Hospital. BMJ Quality Improvement Reports. Volume 4 (1)


Recommendation: 1.8

Referral, admission and discharge following self-harm

What was measured: Patients who had Specialist Mental Health Follow Up
Data collection end: June 2011
38%
Number that met the criteria: / 7599
Area covered: National
Source: 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; Vol 3, e003444 doi:10.1136/bmjopen-2013-003444



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