Surveillance decision

Surveillance decision

We will not update NICE guidelines CG16 or CG133.

NICE guideline CG16 Self-harm in over 8s: short-term management and prevention of recurrence will remain on the static list because:

  • No evidence was identified that would impact on the current guidance and no major ongoing studies or research have been identified as due to be published in the near future (that is, within the next 3–5 years).

Reason for the decision

Self-harm in over 8s: short-term management and prevention of recurrence NICE guideline CG16

We found 50 new studies through surveillance of this guideline.

This included new evidence that supports current recommendations on:

  • Issues for all services and healthcare professionals (users' experience of services, staff training and service planning)

  • Medical and surgical management of self-harm (general treatment for ingestion, management of paracetamol overdose, flumazenil in benzodiazepine overdose, treatment of opioid overdose)

  • Support and advice for people who repeatedly self-harm

  • Psychosocial assessment

  • Special issues for children and young people (under 16 years)

  • Psychological, psychosocial and pharmacological interventions

We asked topic experts whether this new evidence would affect current recommendations in NICE guideline CG16. Generally, the topic experts thought that an update was not needed. However, the majority of topic experts felt that the current distinction between short and long term management of self-harm is rather artificial and suggested considering combining NICE guidelines CG16 and CG133 when an update of the guidelines is decided.

None of the new evidence considered in surveillance of this guideline was thought to have an effect on current recommendations.

We did not find any new evidence on:

  • Issues for all services and healthcare professionals (consent to care, activated charcoal)

  • The management of self-harm in primary care

  • The assessment and initial management of self-harm by ambulance services

  • The treatment and management of self-harm in emergency departments

  • Medical and surgical management of self-harm (paracetamol screening, treatment and management of poisoning with salicylates, general treatment for self-injury)

  • Referral, admission and discharge following self-harm

  • Special issues for older people (older than 65 years)

In addition, no major ongoing studies or research due to be published in the next 3–5 years was identified. Topic experts highlighted an ongoing randomised controlled trial (Self-Harm Intervention Family Therapy [SHIFT]) comparing family therapy against treatment as usual in young people with subsequent episodes of self-harm. However, the SHIFT trial was considered to be relevant for NICE guideline CG133 and will be assessed during the next surveillance review of NICE guideline CG133.

Self-harm in over 8s: long term management NICE guideline CG133

We found 34 new studies through surveillance of this guideline.

This included new evidence that supports current recommendations on:

  • General principles of care (training and supervision for health and social care professionals)

  • Psychosocial assessment in community mental health services and other specialist mental health settings: integrated and comprehensive assessment of needs and risks

  • Longer-term treatment and management of self-harm (interventions for self-harm)

We asked topic experts whether this new evidence would affect current recommendations in NICE guideline CG133. Generally, the topic experts thought that an update was not needed.

None of the new evidence considered in surveillance of this guideline was thought to have an effect on current recommendations.

We did not find any new evidence on:

  • General principles of care (working with people who self-harm, access to services, self-harm and learning disabilities, consent and confidentiality, safeguarding, families, carers and significant others, managing endings and supporting transitions)

  • Primary care

  • Longer-term treatment and management of self-harm (provision of care, care plans, risk management plans, provision of information about the treatment and management of self-harm, harm reduction)

  • Treating associated mental health conditions

Equalities

No equalities issues were identified for either NICE guideline CG16 or CG133 during the surveillance process.

Overall decision

After considering all the new evidence and views of topic experts, we decided not to update NICE guidelines CG16 and CG133, and leave NICE guideline CG16 on the static list.

Consideration will be given to combining both NICE guidelines CG16 and CG133 during a future update.

See how we made the decision for further information.


This page was last updated: 30 September 2016