Hostname: page-component-78c5997874-j824f Total loading time: 0 Render date: 2024-11-15T15:17:06.078Z Has data issue: false hasContentIssue false
  • English
  • Français

Deliberate self-harm (DSH) out of hour's presentations

Published online by Cambridge University Press:  13 June 2014

Fiona McNicholas ,
Michael O'Sullivan ,
Ruth Lennon ,
Mairin Doherty  and
Neil Adamson
Fiona McNicholas*
Affiliation:
Department of Child Psychiatry, Our Lady's Hospital for Sick Children, Crumlin, Dublin 12, Lucena Clinic, Rathgar and University College, Dublin, Ireland
Michael O'Sullivan
Affiliation:
Department of Child Psychiatry, Our Lady's Hospital for Sick Children, Crumlin, Dublin 12, Lucena Clinic, Rathgar and University College, Dublin, Ireland
Ruth Lennon
Affiliation:
Research Psychologist, Lucena Clinic, Rathgar and University College, Dublin, Ireland
Mairin Doherty
Affiliation:
Department of Child Psychiatry, Our Lady's Hospital for Sick Children, Crumlin, Dublin 12, Ireland
Neil Adamson
Affiliation:
Department of Child Psychiatry, Our Lady's Hospital for Sick Children, Crumlin, Dublin 12, Ireland
*
*Correspondence E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective: To establish time of presentation to paediatric accident and emergency (A&E) services of children with deliberate self-harm (DSH).

Method: All children presenting to an acute paediatric hospital with DSH or suicidal ideation between 1993-2003 were identified and time of presentation collected from their case notes.

Results: Of the 172 children where the actual time of presentation was recorded, the majority of children – 137 (80%) presented to the hospital outside of the ‘normal working hours’ of 9am-5pm, Monday – Friday. These children represent an at-risk group, and were more likely to have consumed alcohol, to have made a suicide attempt, and to have a family history of psychiatric illness than children presenting with “normal working hours”.

Conclusion: DSH in young people is a significant public health problem in Ireland and is a major risk factor for completed suicide. Access to an out of hours on-call Child and Adolescent Psychiatry (CAP) services is essential if these children are to have a mental health assessment, as recommended by the Royal College of Psychiatry and National Institute of Clinical Excellence. These services need to be urgently developed.

Keywords

Deliberate self-harm (DSH)Suicidal ideationChildren on-call services
Type
Original Papers
Information
Irish Journal of Psychological Medicine , Volume 27 , Issue 1 , March 2010 , pp. 11 - 14
Copyright
Copyright © Cambridge University Press 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Irish College of Psychiatrists, (September 2005). A Better Future Now.Google Scholar
2.Central Statistics Office Ireland (1982-2002).Google Scholar
3.National Institute for Clinical Excellence. (2004). The short-term physical and psychological management and secondary prevention of self-harm in primary and secondary care. National Clinical Practice Guideline Number 16.Google Scholar
4.Hawton, K, Rodham, K, Evans, E. Deliberate self-harm in adolescents: self report survey in schools in England. BMJ 2002; 325(7374): 1207–1211.CrossRefGoogle ScholarPubMed
5.Fortune, S, Hawton, K. Deliberate self-harm in children and adolescents: a research update. Curr Opin Psychiatry 2005; 18:401–406.CrossRefGoogle ScholarPubMed
6.Hawton, K, Hall, S, Simkin, S, Bale, L, Bond, A, Codd, S, Stewart, A. Deliberate self-harm in adolescents: a study of characteristics and trends in Oxford, 1990-2000. J Child Psychol Psychiat 2003; 44 (8): 1191–1198.CrossRefGoogle ScholarPubMed
7.Kerfoot, M, McHugh, B. The outcome of childhood suicidal behaviour. Acta Paedopsychiat 1992; 55: 141–145.Google ScholarPubMed
8.Brent, DA, Baugher, M, Bridge, J, Chen, T, Chiappetta, L. Age and Sex-Related Risk Factors for Adolescent Suicide. J Amer Acad Child & Adol Psychiat 1999; 38(12):1497–1505CrossRefGoogle ScholarPubMed
9.Hawton, K, Fagg, J. Suicide, and other causes of death, following attempted suicide. Brit J Psychiat 1988; 152: 359–366.CrossRefGoogle ScholarPubMed
10.Royal College of Psychiatrists. Managing deliberate self-harm in young people. Council Report CR64. March 1998.Google Scholar
11.Australian College for Emergency Medicine and Royal Australian and New Zealand College of Psychiatrists. Guidelines for the Management of Deliberate Self-harm in Young People. May 2002.Google Scholar
12.Dorer, C. An evaluation of protocols for child and adolescent deliberate self-harm Child Psychol Psychiat Review 1998; 3:156–160.CrossRefGoogle Scholar
13.Nadkarni, A, Parkin, A, Dogra, N, Stretch, DD, Evans, PA. Characteristics of children and adolescents presenting to accident and emergency departments with deliberate self- harm. J Accid Emerg Medicine 2000; 17: 98–102.CrossRefGoogle ScholarPubMed
14.Bergen, H, Hawton, K. Variations in time of hospital presentation for deliberate selfharm and their implications for clinical services. J Affect Disorders 2007; 98(3):227–3.CrossRefGoogle ScholarPubMed
15.Nakamura, JW, McLeod, CR, McDermott, JF. Temporal variation in adolescent suicide attempts. Suicide Life-Threaten Behav 1994; 24(4):343–9.CrossRefGoogle ScholarPubMed
16.Piacentini, J, Rotheram-Borus, MJ, Gillis, JRet al.Demographic predictors of treatment attendance in adolescent suicide attempters. J Consult Clin Psychol 1995; 63:469–473.CrossRefGoogle ScholarPubMed
17.Spirito, A, Plummer, B, Gispert, Met al.Adolescent suicide attempts: outcomes at follow-up. Amer J Orthopsychiat 1992; 62:464–468.CrossRefGoogle ScholarPubMed
18.Granboulan, V, Roudot-Thorava, IF, Lemerle, S, Alvin, P. Predictive factors of postdischarge follow-up care among adolescent suicide attempters. Acta Psychiat Scand 2001; 104(1): 31–36.CrossRefGoogle ScholarPubMed
19.Reach Out. The Irish National Strategy for Action on Suicide Prevention 2005-2014. www.nosp.ieGoogle Scholar
20.UK Department of Health, (October 2004). The Mental Health and Psychological Well-being of Children and Young People.Google Scholar