Skip to main content
Published Online:https://doi.org/10.1027/0227-5910.25.4.183

Abstract: Deliberate self-harm patients who leave the acute hospital environment before the completion of psychiatric assessment have an increased risk of subsequent self-harm. We considered the available data on 50 premature self-discharges identified prospectively in a general hospital with a well-developed integrated-care pathway for self-harm patients, and compared them to a control group. The self-discharge group was found to be more likely to have attempted self-poisoning without alcohol intoxication or other forms or combinations of self-harm, and an absence of identifiable previous self-harm or prior contact with local specialist psychiatric services. The two groups showed no difference in age, sex, or area of residence based on community mental health team sectors. It is proposed that these findings indicate hypotheses for further studies of why people leave the hospital without adequate assessment, and how service design could be improved in order to help them.

References

  • Brent, DA , Moritz, G Developmental pathways to adolescent suicide. In D Cichetti, S Totti (Eds.), Adolescents: Opportunities and challenges. Rochester, NY: University of Rochester Press (1996). First citation in articleGoogle Scholar

  • Crawford, MJ , Wessely, S Does initial management affect the rate of repetition of deliberate self harm? Cohort study. British Medical Journal, (1998). 317, 985– First citation in articleCrossref MedlineGoogle Scholar

  • Ebbage, J , Farr, C , Skinner, DV , White, PD The psychosocial assessment of patients discharged from accident and emergency departments after deliberate self-poisoning. Journal of the Royal Society of Medicine, (1994). 87, 515– 516 First citation in articleMedlineGoogle Scholar

  • Hickey, L , Hawton, K , Fagg, J , Weitzel, H Deliberate self-harm patients who leave the accident and emergency department without a psychiatric assessment: A neglected population at risk of suicide. Journal of Psychosomatic Research, (2001). 50, 87– 93 First citation in articleCrossref MedlineGoogle Scholar

  • Hughes, T , Hampshaw, S , Renvoize, E , Storer, D General hospital services for those who carry out deliberate self-harm. Psychiatry Bulletin, (1998). 22, 88– 91 First citation in articleCrossrefGoogle Scholar

  • Kapur, N , House, A , Creed, F , Feldman, E , Friedman, T , Guthrie, E General hospital services for deliberate self-poisoning: An expensive road to nowhere?. Postgraduate Medical Journal, (1999). 75, 599– 602 First citation in articleCrossref MedlineGoogle Scholar

  • Whyte, S , Blewett, A Deliberate self-harm: The impact of a specialist DSH team on assessment quality. Psychiatry Bulletin, (2001). 25, 98– 101 First citation in articleCrossrefGoogle Scholar