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Self Harm Presentation to ED

The HSE National Clinical Programme for the Assessment and Management of Patients Presenting to Emergency Departments following Self-Harm is a joint initiative between the HSE and the College of Psychiatrists of Ireland. Self-Harm is the single biggest risk factor for completed suicide, increasing the risk of suicide 40-fold, as compared to the general population. In 2016, more than 11,000 people came to Emergency Departments (ED) following self-harm.

 This clinical programme has been operational since 2014. Today the programme is delivered in 24 Emergency Departments with 24 hour service. In 2018 funding was received to extend the programme into the 3 Dublin paediatric hospitals.

Scope of the National Clinical Programme

The National Clinical Programme for Self Harm is a HSE Mental Health Programme and it applies to HSE Mental Health Services for all patients, of all ages, presenting in Emergency Departments (ED) following self-harm, or with suicidal ideation.

Each Clinical Nurse Specialist (CNS) or Psychiatry NCHD on call will assess all patients who present following self-harm or with suicidal ideation to the acute hospital whether the patient comes from the Mental Health Services area or not and in line with hospital acceptance criteria.

The principles of care delivered apply equally to adults and children. The core general recommendations are also applicable to the care of children. Children should be assessed in line with the acceptance criteria / policy for that hospital emergency department.

As patients assessed under this National Clinical Programme have mental health needs a child is defined as any patient under 18 years, and staff should follow the SOP recommendations related to children.

Aims and Objectives

The aims and objectives of the National Clinical Programme for Self-Harm are to:

  • Improve the assessment and management of all individuals who present to ED with self-harm
  • Reduce rates of repeated self-harm
  • Improve access to appropriate interventions at times of personal crisis
  • Ensure rapid and timely linkage to appropriate follow-up care
  • Optimise the experience of families and carers in trying to support those who present with self-harm.

Goals 2019

  • Ensure the full implementation of the National Clinical Programme as agreed in all identified Emergency Departments
  • The National Implementation Advisory Group will revise the Model of Care
  • Prepare a strategy to address the recruitment challenges
  • Monitor activities within the programme using electronic data form and rapid feedback facility
  • Deliver the National Clinical Programme in all 26 adult and 3 Dublin paediatric hospitals
  • Deliver accredited training to CNS and NCHD clinicians
  • Continue to lead and participate in audit and research activities with named partners
  • Report on relevant metrics as part of Connecting for Life suicide reduction strategy
  • Prepare and publish reports on the full implementation of the National Clinical Programme across the services
  • Disseminate findings from the National Clinical Programme at national and international conferences

Contact Details:

National Clinical Lead:Dr. Anne Jeffers
National Nurse Lead:Dr. James O'Mahony
Programme Manager:Ms. Rhona Jennings
Email:rhona.jennings@hse.ie

National Implementation Advisory Group:

The National Implementation Advisory Group were integral to the development of the Model of Care for this National Clinical Programme. The Terms of Reference for the Group can be found in Programme Documents & Resources.

Clinical Research & Audit Steering Group

The Clinical Research & Audit Steering Group were integral to the development of the Model of Care for this National Clinical Programme. The Terms of Reference for the Group can be found in Programme Documents & Resources.

Clinical Strategy and Programmes Division