The variation of self-harm service delivery in the UK: An observational study examining hospital management, service provision and temporal trends

S. Steeg, J. Cooper, O. Bennewith, M. Lowe, D. Gunnell, A. House, K. Hawton, Navneet Kapur

    Research output: Contribution to conferenceOther

    Abstract

    Study objectives: We aimed to describe the variability in management of individuals attending hospital with self-harm, measure the quality of service provision and assess changes since an earlier study in 2001. Methods and Material: Data were collected as part of an observational study involving a stratified random sample of 32 hospitals in England, UK. A tailored, one-page data collection form was completed for each hospital presentation involving self-harm. In addition, key mental health and Emergency Department staff were interviewed about specific aspects of service provision for self-harm patients and responses were mapped to a 'service quality scale'. The study collected data on over 6,000 individuals presenting with more than 7,500 episodes of self-harm during a three-month audit period between 2010 and 2011. Results: Hospitals varied markedly in their management of self-harm presentations. There was a greater than three-fold variation in the proportion of episodes resulting in psychosocial assessment by a mental health specialist and the proportion of episodes admitted to general hospital. The proportion of episodes where a referral for specialist mental health follow up was made varied five-fold by hospital. There was also very wide variation in the proportion of episodes referred to non-statutory services and in those resulting in psychiatric admission. Levels of variability had not reduced since the earlier study. However, scores on the service quality scale had increased by a small degree since 2001. Conclusions: Overall it appears that services for the hospital management of self-harm remain variable despite national guidelines and policy initiatives.
    Original languageEnglish
    Publication statusPublished - Sept 2013
    EventXXVII World Congress of the International Association for Suicide Prevention - Oslo
    Duration: 24 Sept 201328 Sept 2013

    Conference

    ConferenceXXVII World Congress of the International Association for Suicide Prevention
    CityOslo
    Period24/09/1328/09/13

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