Book contents
- Frontmatter
- Contents
- Editors
- Contributors
- Foreword
- Preface
- Introduction
- Completing an audit project
- I Disorders
- 1 Acute confusion: recognition
- 2 Antenatal and postnatal mental health
- 3 Attention-deficit hyperactivity disorder: provision of information
- 4 Bipolar depression: treatment
- 5 Bipolar disorder: management
- 6 Bipolar disorder: shared decision-making
- 7 Bipolar disorder: treatment
- 8 Chronic fatigue syndrome
- 9 Dementia: driving
- 10 Dementia: end-of-life care
- 11 Dementia: investigations
- 12 Depression: management in children and young people
- 13 Eating disorders: management
- 14 Epilepsy: management
- 15 Opiate dependence and pregnancy
- 16 Schizophrenia: family interventions
- 17 Schizophrenia: management
- 18 Schizophrenia: occupational achievements
- 19 Self-harm: assessment
- 20 Self-harm: assessment in children
- II Legislation
- III Physical health
- IV Record-keeping
- V Service provision
- VI Training
- VII Treatment
- Appendices
19 - Self-harm: assessment
from I - Disorders
Published online by Cambridge University Press: 02 January 2018
- Frontmatter
- Contents
- Editors
- Contributors
- Foreword
- Preface
- Introduction
- Completing an audit project
- I Disorders
- 1 Acute confusion: recognition
- 2 Antenatal and postnatal mental health
- 3 Attention-deficit hyperactivity disorder: provision of information
- 4 Bipolar depression: treatment
- 5 Bipolar disorder: management
- 6 Bipolar disorder: shared decision-making
- 7 Bipolar disorder: treatment
- 8 Chronic fatigue syndrome
- 9 Dementia: driving
- 10 Dementia: end-of-life care
- 11 Dementia: investigations
- 12 Depression: management in children and young people
- 13 Eating disorders: management
- 14 Epilepsy: management
- 15 Opiate dependence and pregnancy
- 16 Schizophrenia: family interventions
- 17 Schizophrenia: management
- 18 Schizophrenia: occupational achievements
- 19 Self-harm: assessment
- 20 Self-harm: assessment in children
- II Legislation
- III Physical health
- IV Record-keeping
- V Service provision
- VI Training
- VII Treatment
- Appendices
Summary
Setting
This audit is relevant to all mental health professionals who assess patients who present with self-harm to accident and emergency (A&E) departments (e.g. liaison workers, home treatment teams and on-call psychiatrists).
Background
Self-harm is a common presentation to A&E departments. All patients presenting thus should receive a comprehensive assessment. This audit was part of a regional audit comparing self-harm assessments in different A&E departments.
Standards
The standards were obtained from a 2004 guideline on self-harm produced by the National Institute for Health and Clinical Excellence (NICE). It states that every person who self-harms and presents to the health service should receive a comprehensive assessment of psychosocial needs and risk by a healthcare professional. As defined in standards 8 and 9 from the guideline, this assessment should include all the following information:
ᐅ social situation (living arrangements, work, debt)
ᐅ personal relationships
ᐅ recent life events and current difficulties
ᐅ psychiatric history (previous self-harm, drug and alcohol use)
ᐅ mental state examination
ᐅ enduring psychological characteristics associated with self-harm
ᐅ motivation for the act
ᐅ characteristics of the act (intent, planning, violent methods)
ᐅ characteristics of the person (hopelessness, forensic history, future suicidal intent)
ᐅ circumstances of the person (social class, physical illness, social isolation, bereavement).
Any decision to refer for further management must be based upon the combined needs and risk assessment.
Method
Data collection
ᐅ All self-harm assessments completed by mental health professionals were identified for a certain time period. The records were retrieved from different locations (e.g. liaison notes, A&E notes, home treatment notes).
ᐅ The hospital used a specific self-harm assessment tool, which made data collection easier.
ᐅ A data-collection tool was used to determine whether all the relevant information required by NICE had been recorded at each assessment.
Data analysis
The percentage of assessments that had recorded each part of the needs and risk assessment was calculated.
Resources required
People
As this was part of a regional audit, several people were involved at different locations. Approximately two people per hospital are required.
Time
It is estimated that data collection for 50 cases will take 6 hours.
- Type
- Chapter
- Information
- 101 Recipes for Audit in Psychiatry , pp. 57 - 58Publisher: Royal College of PsychiatristsPrint publication year: 2011