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Severity of hospital-treated self-cutting and risk of future self-harm: a national registry study
- Authors:
- LARKIN Celine, et al
- Journal article citation:
- Journal of Mental Health, 23(3), 2014, pp.115-119.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
Background: Risk assessment forms a key component in self-harm management. Among self-harm presentations generally, lethality of an index act is a poor predictor of future non-fatal repetition. However, no study has examined whether severity of an index self-cutting episode is associated with prospective repetition. Aims: To examine factors associated with severity of self-cutting and in particular the association between severity of self-cutting and prospective repetition of self-harm. Methods: All index self-cutting presentations to emergency departments in Ireland over 5 years were grouped by treatment received and compared on the basis of demographic and clinical characteristics. Results: Receiving more extensive medical treatment was associated with male gender, being aged more than 15 years, and not combining self-harm methods. Receiving less extensive treatment conferred a higher risk of prospective 12-month repetition, even after controlling for demographic and clinical characteristics. Repeat self-harm presentations by those with more severe self-cutting in an index act were less prevalent but were more likely to involve high-lethality methods of self-harm. Discussion: The results indicate that the already-elevated repetition risk among self-cutting patients is further increased for those receiving less extensive wound closure treatment. Severity of self-cutting might also affect suicide risk but such an association has yet to be examined. (Publisher abstract)
Compliance with NICE guidelines in the management of self-harm
- Authors:
- MULLINS Diane, MACHALE Siobhan, COTTER David
- Journal article citation:
- Psychiatrist (The), 34(9), September 2010, pp.385-389.
- Publisher:
- Royal College of Psychiatrists
Five percent of people attending accident and emergency services show signs of psychiatric problems, and another 20-30% have psychiatric symptoms as well as physical disorders. The most common problem presented is self-harm. This study aimed to identify the provision of psychosocial assessments for all people attending an accident and emergency department in Ireland with a presentation indicative of self-harm over a 12 month period, and examined whether the National Institute for Health and Clinical Excellence (NICE) guidelines for self-harm were met. A total of 834 attendances for self-harm were recorded. Findings showed that a psychosocial assessment was undertaken by a member of the liaison psychiatry team in 59% of attendances, but single male patients under 45 years of age represented 39% of those who did not receive a psychosocial assessment. In order to meet the NICE guidelines for standards of care it is suggested that levels of psychosocial assessment need to be improved for single men under the age of 45 years.
Group-based problem-solving therapy in self-poisoning females: a pilot study
- Author:
- BANNAN Noreen
- Journal article citation:
- Counselling and Psychotherapy Research, 10(3), September 2010, pp.201-213.
- Publisher:
- Wiley
In this pilot study 18 females (aged 18 to 53 years) who had presented to an accident and emergency department of an inner city hospital in Ireland following an episode of deliberate non-fatal self-poisoning were equally randomised to a time-limited, group-based problem-solving intervention or to a treatment as usual control group. The intervention group underwent 8 sessions of group therapy each lasting 150 minutes, with the initial 4 sessions held twice weekly, the next two sessions held weekly, and the final two sessions held at two week intervals. The control group received standard individual therapy in the outpatients or day hospital. All clients were assessed using standardised questionnaires for depression, hopelessness, suicidal ideation and social problem-solving skills. Adherence with therapy was good with only one client in each group failing to adhere to the treatment schedule. The treatment group experienced significant reductions in levels of depression, hopelessness, suicidal ideation and improvements in self-assessed social problem-solving skills. Improvements in mental health and aspects of self-assessed problem-solving skills continued to be evident at two months follow-up in this group. The control group did not change significantly over time on mental health measures or social problem solving abilities. The authors conclude that these preliminary findings suggest that group-based problem-solving therapy is effective in the management of deliberate self-poisoning.
Practical interventions for young people at risk
- Editors:
- GELDARD Kathryn, (ed.)
- Publisher:
- Sage
- Publication year:
- 2009
- Pagination:
- 213p.
- Place of publication:
- Los Angeles, CA
This book brings together contributions from the UK, Ireland and the rest of Europe, USA, Australia and New Zealand, that cover existing practices for interventions with young people at risk, that are positive in nature, such as the collaboration between multi-disciplinary teams and young people, joint-working practices and building on some young peoples’ strengths during adolescence, of inherent resilience, peer group support and mentoring, and ability to self care. In addition, Parts III to VIII detail the darker topics of suicide and self-harm, confrontational behaviour (including gangs, bullying and fire-starting), substance misuse, sexual behaviour (including health and sexuality issues), mental health problems (including eating disorders, depression, cult group membership) and marginalised young people and looked after children, with the various, expert contributors giving their ideas on the best methods for risk assessment and practical interventions with vulnerable young people experiencing these difficulties. Themes of anti-oppressive practice, and the importance of culture, values and ethics run throughout the 17 chapters of text as well as the editor’s introduction and summary.