Rapid access to brief psychological treatments for self-harm and suicidal crisis.

Abstract

Suicide is an important public health issue. Over 800 000 people die by suicide each year worldwide,1 and approximately 6000 people per year in the UK.2 Self-harm is a public health priority.3 Self-harm is defined as any intentional act of self-injury or self-poisoning regardless of motivation or suicidal intent.4 Self-harm is associated with personal and social difficulties, as well as increased risk of suicide and premature death by other causes. The number of presentations for suicidal crisis without physical injury at emergency departments is unknown. In the UK, the increasing impact of those visits is evident through the increasing number of community crisis resolution/home treatment/‘first response’ schemes, and more recently the Core 24 response initiative.5 The Core 24 response initiative involves the provision of care for people experiencing a mental health crisis who attend in emergency departments, available 24 hours a day, 7 days a week. For self-harm, there are over 200 000 presentations to emergency departments annually.4,6 This includes people who have physically harmed themselves without suicidal intent and those who have attempted to die by suicide. However, it is important to note that many people who self-harm do not present to hospital and may be managed within community settings. The true prevalence of self-harm or suicidal crisis is therefore estimated to be much higher.7 There are potential lifelong implications of non-suicidal self-harm and suicide attempts, such as an increased frequency of suicide, especially if the behaviours are adopted as …