Abstract
Aims and methodTo 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 12 months and to investigate whether the National Institute for Health and Clinical Excellence (NICE) guidelines for self-harm were met.ResultsA total of 834 attendances for self-harm were recorded. A psychosocial assessment was undertaken by a member of the liaison psychiatry team in 59% of attendances. Single male patients under 45 years of age represented 39% of those who did not receive a psychosocial assessment.Clinical implicationsSingle men under the age of 45 years represent a vulnerable group in which levels of psychosocial assessment need to be optimised in order to meet the NICE guidelines for standards of care.
Highlights
Clinical implications Single men under the age of 45 years represent a vulnerable group in which levels of psychosocial assessment need to be optimised in order to meet the National Institute for Health and Clinical Excellence (NICE) guidelines for standards of care
The provision of psychosocial assessments was noted to be significantly less than that recommended by the NICE guidelines, with 41% of those attending A&E leaving without a psychosocial assessment
This finding is in keeping with levels of 46% reported in a study of four teaching hospitals and with that of an 8-week audit of 31 general hospitals in Factor Gender Age (545 years v. 545 years) Method Disclosure of past self-harm Disclosure of a psychiatric history Time of presentation (09.00-17.00 h Monday to Friday v. out of hours) Medical admission
Summary
Beaumont Hospital has 720 beds and is one of the largest general hospitals in Ireland, providing acute hospital care for the north Dublin area, a region of significant socioeconomic deprivation. The proportion of episodes assessed by psychiatry was higher for female attenders (n = 274; 56%) than males and higher in those less than 45 years of age (n = 401; 81%) than in older individuals More of those under 45 years old with a history of self-harm and who disclosed a past psychiatric history received a psychosocial assessment. Of this group, 133 (39%) were single males under the age of 45 years, 202 (59%) had a history of psychiatric illness (Pearson w2 = 4.82, P = 0.028) and 149 (44%) had a history of self-harm (Pearson w2 = 21.10, P50.001).
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