Psychiatric Bulletin (2003) 27: 233. doi: 10.1192/pb.27.6.233-a
© 2003 The Royal College of Psychiatrists
Psychiatric Bulletin (2003) 27: 233
© 2003 The Royal College of Psychiatrists
Assessment by doctors and nurses of deliberate self-harm
Peter Lepping
Department of Liaison Psychiatry, West Cheshire Hospital, Liverpool Road,
Chester CH2 1BQ
Sian Weston (Psychiatric Bulletin, February 2003, 27, 57-60) points out the
differences between doctors and nurses assessing deliberate self-harm. From my
experience looking at the Liaison Psychiatry service in Chester and Wirral, I
can certainly confirm her findings that doctors are much more likely to refer
to other doctors for follow-up. This was confirmed in a recent audit that we
did locally. I feel that this finding is more accurate than the previous
limited research discussed.
The reasons for this might be that inexperienced Senior House Officers want
to be safe and therefore feel that an additional psychiatric opinion can aid
in this process. It is also possible, however, that publication bias played a
part in the previous articles, because the main aim of most of these papers
was to prove that nurses' assessments are as good as doctors' assessments, a
finding with obvious resource implications. In light of Sian Weston's
findings, it certainly remains unclear whether we can be sure at this point
that the consequences of being seen by a nurse or by a doctor are actually the
same for the patients with regards to follow-up arrangements.