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Increasing psychosocial assessment by introducing a self-harm pathway

North Wales Section of Psychological Medicine, University of Wales Academic Unit, Technology Park, Wrexham, Wales LL13 7YP, e-mail: peter.lepping{at}new-tr.wales.nhs.uk

Barbara Woodworth, Team Manager/Nurse Specialist Liaison Psychiatry

Arrowe Park Hospital, Wirral

Lucy Roberts, Integrated Care Pathways Facilitator

Wrexham Maelor Hospital

Jim Turner, Senior Research Fellow

North East Wales NHS Trust, Wrexham

Declaration of interest

None. Funding detailed in Acknowledgements.

AIMS AND METHOD

To audit whether the introduction of a self-harm pathway and protocol increases the number of psychosocial assessments. All episodes of self-harm in a defined period during 2002 (n=335) and 2004 (n=390) were reviewed before and after the introduction of a self-harm pathway and protocol. Adherence to the protocol was also investigated.

RESULTS

After the introduction of the self-harm pathway and protocol, the proportion of psychosocial assessments requested had risen from 57% (2002) to 85% (2004). The proportion of psychosocial assessments completed had risen from 47% to 70%. Over the 2 years, the overall number of self-harm presentations was reduced by 27%.

CLINICAL IMPLICATIONS

The introduction of a self-harm pathway and protocol through a self-harm steering group is feasible, was well accepted and increased the number of psychosocial assessments after self-harm. It may also contribute to a reduction in the number of overall presentations with self-harm to the accident and emergency department.