While it is standard practice for patients being admitted to hospital because of self-harm to receive psychosocial assessment before discharge, many of these assessments in the United Kingdom and elsewhere are undertaken by trainee rather than specialist psychiatrists. A paper published in a recent issue of Crisis: The Journal of Crisis Intervention and Suicide Prevention presented the results of a study comparing psychosocial assessments, aftercare, and the pattern of non-fatal repetition for patients admitted to general hospital after self-harm and whether there was a substantial difference between the assessments carried out by trainee psychiatrists or by mental health nurses with a designated role in self-harm services. The study compared arrangements for aftercare and rates of non-fatal repetition of self-harm in 787 consecutive psychosocial assessments in a large UK city, according to whether the assessments were carried out by trainee psychiatrists or mental health nurses. Results showed that, compared with nurses, psychiatrists were much more likely to arrange psychiatric admission or outpatient follow-up. Nurses more often pointed people towards voluntary sector help—such as drug, alcohol or relationship counselling. Repetition of self-harm was equally common among those assessed by nurses or psychiatrists (33%; hazard ratio 0.93, 95% confidence interval 0.71 to 1.2). The authors concluded that despite making fewer aftercare arrangements that involved statutory mental health care services, psychosocial assessment by mental health nurses showed no sign of detrimental effects on repetition of self-harm.
While it is standard practice for patients being admitted to hospital because of self-harm to receive psychosocial assessment before discharge, many of these assessments in the United Kingdom and elsewhere are undertaken by trainee rather than specialist psychiatrists. A paper published in a recent issue of Crisis: The Journal of Crisis Intervention and Suicide Prevention presented the results of a study comparing psychosocial assessments, aftercare, and the pattern of non-fatal repetition for patients admitted to general hospital after self-harm and whether there was a substantial difference between the assessments carried out by trainee psychiatrists or by mental health nurses with a designated role in self-harm services. The study compared arrangements for aftercare and rates of non-fatal repetition of self-harm in 787 consecutive psychosocial assessments in a large UK city, according to whether the assessments were carried out by trainee psychiatrists or mental health nurses. Results showed that, compared with nurses, psychiatrists were much more likely to arrange psychiatric admission or outpatient follow-up. Nurses more often pointed people towards voluntary sector help—such as drug, alcohol or relationship counselling. Repetition of self-harm was equally common among those assessed by nurses or psychiatrists (33%; hazard ratio 0.93, 95% confidence interval 0.71 to 1.2). The authors concluded that despite making fewer aftercare arrangements that involved statutory mental health care services, psychosocial assessment by mental health nurses showed no sign of detrimental effects on repetition of self-harm.
For the abstract .