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Assessing young people who deliberately harm themselves.
The British Journal of Psychiatry : the Journal of Mental Science
|February 7, 2001
Summary
Many young individuals engaging in self-harm are not identified for specialist assessment in accident and emergency (A&E) clinics, potentially delaying crucial mental health treatment.
Area of Science:
- Psychiatry
- Public Health
- Adolescent Medicine
Background:
- Young people self-harming often have underlying mental health or social issues.
- Accident and emergency (A&E) departments serve as critical access points for treatment.
- Self-harm in youth can indicate future suicide risk.
Purpose of the Study:
- To detail the psychosocial assessment of adolescents and young adults (12-24 years) after deliberate self-harm (DSH) in A&E.
- To identify service management factors that enhance specialist assessment for these patients.
Main Methods:
- A postal questionnaire was distributed to A&E departments across England.
- Interviews with staff and examination of 50 case notes per hospital were conducted in 18 selected hospitals.
Main Results:
- Psychosocial assessments by non-specialist A&E doctors varied in quality and focused on immediate risk.
- Only 43% of young patients (12-24) received specialist assessment.
- Specialist assessment correlated with higher admission rates and availability of on-site psychiatric services and DSH teams.
Conclusions:
- At-risk young patients who self-harm are frequently missed, leading to untreated psychological problems.
- Hospitals often lack awareness regarding the number of patients discharged without thorough assessment.
- Improved identification and specialist assessment are crucial for this vulnerable population.