P0301 - Assessment of deliberate self-harm in patients attending an accident and emergency department

Abstract

Aims:

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

Background Review:

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.

Method:

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.

Results:

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.

Conclusions:

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.