Abstract
Aims and Method To compare the assessment by community psychiatric nurses and junior psychiatric doctors of individuals following deliberate self-harm (DSH) and, in particular, to elicit differences in referral practices and perceptions of mental illness. The health professionals involved completed questionnaires after carrying out DSH assessment. Results There was a significant difference in referral patterns between doctors and nurses after DSH assessment. Doctors were significantly more likely to refer individuals for psychiatric follow-up which involved direct contact with other doctors (51 of 72 (71%) compared with 60 of 175 (34%)). Doctors were also significantly more likely than nurses to perceive individuals as having a mental illness (57 of 72 (79%) compared with 86 of 175 (49%)). Clinical Implications Further research is warranted to establish the precise reasons for these differences, and to determine whether the widespread introduction of nurse-led services is an effective and efficient use of resources.
Highlights
All patients with deliberate selfharm (DSH) admitted to Morriston or Singleton Hospitals between 1 May and 31 October 2000 were included in the study if they satisfied the following criteria: (a) they were assessed by a junior psychiatric doctor or community psychiatric nurse (CPN) within either of the two specific components of the DSH service outlined above; (b) they were aged 16 years or over and had left fulltime education; (c) the method of DSH involved self-poisoning
There is a huge discrepancy between CPNs and junior doctors both original papers in perceptions of mental illness and in referral practice
Either the CPNs are discharging a large number of individuals who have severe problems or the junior doctors are unnecessarily referring on to services patients who do not require treatment
Summary
To compare the assessment by community psychiatric nurses and junior psychiatric doctors of individuals following deliberate selfharm (DSH) and, in particular, to elicit differences in referral practices and perceptions of mental illness. The health professionals involved completed questionnaires after carrying out DSH assessment
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