Patients presenting with self harm account for a significant proportion of attendances to the emergency department. NICE guidelines recommend these patients must undergo full psychosocial and risk assessment with mental state examination.

Aims included to investigate the demographic factors of those presenting to the emergency department with self harm and explore methods of self harm. Also, to review the psychiatric history, exploration of suicide risk factors and assessment of suicidal intent, the mental state examination and referral for further treatment.

We also wished to make recommendations to improve the history taking process should this be proved necessary.

Data was collected retrospectively from February to August 2009. Twenty-five casualty cards were collated at random for patients who presented with self harm. Evidence of exploration of the objectives were investigated.

Suicide risk factors and suicidal intent were poorly documented. The mental state examination was not documented in all cases. 18 were referred for psychiatric review.

Psychosocial and risk assessment of those presenting to the emergency department with self harm is poor. As a result of this study, We have designed and introduced a proforma to be completed by doctors in the emergency department. This incorporates the mental state examination and is to aid the assessment of suicidal intent in patients presenting with self harm. The effectiveness of this proforma will be assessed with a re-audit planned in 3 months time.