National Clinical Programme for the Assessment and Management of Patients presenting to Emergency Department following Self Harm

Suicide is well recognised as a serious public health issue with 11,126 self-harm presentations to Emergency Departments (ED) in Ireland and 459 deaths in 2014. It requires a diversity of responses: social, educational, occupational and health related.

 

The HSE (Clinical Strategy and Programmes Division and the Mental Health Division) in partnership with the College of Psychiatrists’ of Ireland are delighted to publish this National Clinical Programme. This Clinical Programme is a part of an overall strategy and specifically addresses the care and treatment required by people who present to the Emergency Departments (ED) of acute hospitals following an episode of self-harm.

 

This Programme aims to provide a standardised specialist response to all such people and, by so doing, reduce the numbers leaving Emergency Departments without an assessment, link people into appropriate care, involve families and friends as appropriate with an overall aim of reducing repetition which is known to be associated with an increased risk of completed suicide.

 

The HSE has funded 33.5 clinical nurse specialist nurses located in emergency departments across the country to deliver the programme in addition to the teams and staff already in place. This is in line with the objectives in the HSE National Service Plan. To date the Clinical Programme is operational in 16 EDs and efforts continue to recruit specialists’ nurses to vacant posts.  

 

In tandem with the Programme a training plan has been developed to ensure that staff are skilled and have on-going opportunities to develop competencies and have access to supervision in this clinical area. Training has also been provided to emergency health care staff working with self-harm or suicidal patients to foster improved knowledge of self-harm, more positive attitudes and increased confidence in assessing and managing people in the ED.   

 

Multidisciplinary community mental health teams for all age groups have been developed and expanded in recent years by the HSE and are able to respond to acute mental health problems on the same day. However, there will always be people who directly access Emergency Departments either by choice or necessity and hence it is essential to ensure that staff with the requisite skills are available to meet their needs in a timely fashion.

 

The National Clinical Programme for the Assessment and Managment of Patients presenting to Emergency Department following Self Harm is linked to Action 4.1.5 in Connecting for Life, which is Ireland’s National Strategy to Reduce Suicide (2015-2020).

 

Further information about the Programme is available here

Last updated on: 16 / 03 / 2016