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The Management of Parasuicide in Young People under Sixteen

1. In order to provide an adequate service a child psychiatric team should be directly involved with all parasuicidal children and their families, and the team should be strengthened to facilitate this. The team should be available for consultation with ward staff during the assessment, and more widely available to other professionals at follow-up. Evaluative studies should be undertaken to monitor the effectiveness of such arrangements.

2. In some areas, it is unrealistic to expect rapid intervention by the child psychiatrist without additional resources being made available.

3. The family doctor occupies the centre of the health network of services and should be fully informed.

4. Hospital admission is desirable in most cases of parasuicide in children and adolescents.

5. Young people up to 14 years of age should be admitted to a paediatric ward rather than to a general surgical or medical ward. Older children should ideally be admitted to an adolescent medical ward, if this is available.

6. Hospital staff are responsible for making contact with the parents or guardian of the young person in order to seek their participation in a psychiatric assessment, and for alerting the child psychiatric team.

7. The deployment of the child psychiatric team is a matter for the individual child psychiatrist concerned. Responsibility lies primarily with the psychiatrist who may decide to delegate that responsibility to others if he so wishes.

8. The child psychiatric team may offer follow-up directly, or be available for consultation to other professionals undertaking this. Where an adolescent is unable to return home because of a disrupted family situation, it will then be the responsibility of the Social Services Department to provide an alternative placement.

9. If an adolescent is judged to be too psychiatrically disturbed to be discharged home, then in-patient treatment may be needed in a psychiatric unit catering for the appropriate age range.