Abstract
A service enhancement program for deliberate self-harm (DSH) patients in two area mental health services in New South Wales, Australia, examined the effectiveness of emergency cards ('Green Cards') in enhancing patients' return rates, and perceived effectiveness by service personnel. Eighty-four percent of patients receiving a Card attended their appointment, compared with 40% receiving another form of referral. The Card did not ensure treatment continuation. Staff feared it might increase referral rates, reinforce DSH behavior and create more work, but this was unsubstantiated. Though Green Cards may be efficacious, their use in health service enhancement brings challenges for implementation not usually discussed in DSH intervention studies. Working with staff regarding barriers to such strategies is crucial to their adoption and success. This report finds the Green Card effective for patients engaging in DSH.
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