To study the presenting features and outcome of deliberate self-harm patients presenting to an accident and emergency department

Self-harm accounts for up to 170,000 hospital attendances in the UK annually. 15-25% repeat self-harm within 1 year. Self-harm repetition is reported as higher among those who do not receive psychosocial assessments and discharge themselves from accident and emergency departments.

All patients triaged within Beaumont Hospital accident and emergency department with a presentation indicative of psychiatric disorder were studied over 12 months. The following were collected on each patient: demographic variables (age, gender, marital status), clinical variables (method of self-harm including associated factors, history of deliberate self-harm, overdose agents used in self-poisoning, whether a psychiatric consultation occurred and outcome). Dates and times of presentations were recorded. Statistical analysis was performed using SPSS14 statistical package.

1,397 liaison psychiatry patients presented to the accident and emergency department over 12 months. 834 (60%) cases were deliberate self-harm, most commonly overdose (47%). 353 (35%) cases of self-harm were associated with alcohol ingestion. Most self-harm presentations (30%) occurred in March (83), April (86) and May (83). Most self-harm cases (27%) presented between 9pm-1am. 27% of self-harm cases presented between 9am-5pm when psychiatric cover was available in the accident and emergency department. 73% presented outside of these hours. 273 (20%) liaison psychiatry patients left before psychiatric consultation.

Optimisation of the management of patients who self-harm is important. The reasons why patients leave hospital before assessment has been completed should be further investigated.