Self Harm Presentation to ED: National Clinical Programmes

People who self-harm or present with suicide-related ideation are at increased risk of suicide. Providing expert interventions at times of crisis improves both engagement with services and outcomes.

In 2016 the National Clinical Programme for the Assessment and Management of Patients who present to the Emergency Department (NCPSH) Model of Care (MOC) was introduced. It established a clinical framework to ensure that any person who presents to the ED following self-harm or with suicide-related ideation receives a compassionate, empathic, validating response, and a therapeutic assessment and intervention from a suitably trained mental health professional; that every effort is made to ensure that a family member or supportive adult is involved in assessment and safety planning, and that they are followed up and linked to appropriate next care.

In February 2022 the Clinical Programme was updated.  This update has built on the learning over the last five years of implementing the programme in ED. It provides a framework to improve services for all who self-harm or present with suicide-related ideation, regardless of where they present. The changes recommended have been informed by evidence, by the experience of clinicians and managers, and by feedback from individuals and family members with lived experience of self-harm and suicide

Scope

To ensure this clinical programme is embedded into everyday clinical practice so that every individual who presents to General Practice, Emergency Department, Community Mental Health Team or CAMHS following self-harm, or with suicide-related ideation, will receive a timely, expert assessment of their needs, and is connected to appropriate next care. That the individual and their family are valued and supported, by staff who themselves are valued and supported. 

Programme Objectives

  • To improve the interventions and support for people who self-harm or have suicide-related ideation.
  • To reduce repeated self-harm.
  • To improve access to appropriate interventions at times of personal crisis, ensuring the person receives the right intervention, at the right time, in the right place and by the right person.
  • To ensure rapid, timely and safe linkage to appropriate follow-up care.
  • To optimise the experience of families and carers in trying to support those who present with self-harm or with suicide-related ideation

Goals 2024

  • Progress and report on the full implementation of the National Clinical Programme for self-harm and suicide related Ideation including in emergency departments and primary care via SCAN (Suicide Assessment Crisis Nurse) with National Implementation Advisory Group.
  • Collect and collate clinical activity data from each site/service. Report on findings and trends annually or as required.
  • Provide accredited training and education to clinicians in line with programme objectives
  • 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
  • Disseminate findings from the National Clinical Programme at national and international conferences and published papers.
Contact Details:
National Clinical Lead:In recruitment

National Nurse Lead:

Ms. Sally Lovejoy

Database Manager:

Dr. Maeve Cosgrove
Programme Manager:Ms. Rhona Jennings
Email:rhona.jennings@hse.ie
Twitter:@NCP_SHSI

Note that if you are in crisis or in need of support, you should contact a relevant mental health support service, or in an emergency, get urgent help

National Implementation Advisory Group:

The National Implementation Advisory Group were integral to the development of the Model of Care for this National Clinical Programme.