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Effective Health Care Deliberate self-harm ■ Deliberate self-harm involves.pdf

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Effective Health Care Deliberate self-harm ■ Deliberate self-harm involves

Bulletin on the effectiveness of health service interventions for decision makers NHS Centre for Reviews and Dissemination, University of York DECEMBER 1998 VOLUME 4 NUMBER 6 ISSN: 0965-0288 Effective Health Care Deliberate self-harm The contents of this bulletin are likely to be valid for around one year, by which time significant new research evidence may have become available. ■ Deliberate self-harm involves intentional self-poisoning or injury, irrespective of the apparent purpose of the act. It is one of the top five causes of acute medical admissions for both women and men in the UK.■ All hospital attendance following deliberate self- harm should lead to a specialist psychosocial assessment. This should identify motives for the act, and those associated problems which are potentially amenable to intervention such as psychological or social problems, mental disorder, alcohol and substance misuse. ■ Direct discharge from AE should only be contemplated if a psychosocial assessment and aftercare plan can be arranged prior to discharge. Aftercare arrangements should include advice on the services available. ■ GPs should have ready access to training and advice about the assessment and management of self-harm patients in primary care.■ Accessible and comprehensive services need to include a mechanism for engaging people who do not attend routine clinic appointments. Access to follow-up needs to be rapid as repetition can occur soon after the episode.■ Service providers should work to improve attitudes towards self-harming patients, for example through training aimed at increasing knowledge.■ There is insufficient evidence to recommend a specific clinical intervention after deliberate self-harm. Further research is needed to establish the effectiveness of potential interventions. A. Background Deliberate self-harm involves intentional self-poisoning or self injury, irrespective of the apparent purpose of the act.1 Self-poisoning, for example an overdose, is the