Self-harm guideline to help raise standard of NHS care

People who harm themselves are not getting the same quality of treatment on the NHS as they deserve as few people providing care in casualty understand why people self-harm and do not know how to help them effectively, a health service watchdog has said today.

The watchdog has estimated that 80,000 people do not receive a psychological assessment or follow up even though the risk of committing suicide after self-harming one or more times is 100 times greater than the average risk in the population.

Every year around 170,000 people who have harmed themselves attend emergency departments throughout England and Wales. Self-harm and suicide have now become the third leading cause for life years lost after cancer and heart disease in all age groups.

A new guideline on self-harm, from the National Institute for Clinical Excellence (Nice) and the National Collaborating Centre for Mental Health (NCCMH), states that people who have self-harmed should be treated with the same care, respect and privacy as any patient and that healthcare professionals should take into account the distress associated with self-harm.

The guideline contains recommendations for the physical, psychological and social assessment and treatment of people in the first 48 hours after having self-harmed.

According to Nice and the NCCMH, all people who have self-harmed should be offered a preliminary psychosocial assessment to determine mental capacity, level of distress and possible presence of mental illness.

All people who have self-harmed should be assessed for future risk of self-harm and/or suicide and the key psychological characteristics associated with risk, in particular depression, hopelessness and continuing suicidal intent should be identified, the guidelines states.

Andrea Sutcliffe, Executive Lead on the guideline at NICE, said: “This guideline is an important step in improving health professionals’ understanding of self harm and what services should be offered to people immediately after an episode of self harm.

"It makes clear that people who self harm should be treated with the same dignity and respect as any other patient and the distress they experience should be taken into account"

Professor Paul Lelliott, Professor of Psychiatry and chair of the guideline development group said: “Ensuring that people who have self harmed are fully informed about their treatment options and understand what is happening to them whilst in NHS care is essential. The guideline clearly highlights the importance of providing full information about treatment and making all efforts necessary to ensure that someone who has self harmed can, and has the opportunity to, give meaningful and informed consent before each procedure or treatment is initiated.”

The UK’s first major investigation into issue, 'A National Inquiry into Self-harm among Young People', was launched on 30 March 2004.

The Inquiry Panel will meet regularly for eighteen months, and interim reports will be available prior to the publication of the final report in the autumn of 2005.

(gmcg)