One in three adults are not provided with a psychosocial assessment following hospital treatment for self-harm, a new study from Orygen has revealed.
The global study, recently published in the British Journal of Psychiatry, analysed 119 publications reporting data on 140,021 individuals and more than 2.2 million episodes of self-harm across 26 countries. It found that a significant number of people treated for self-harm, including a quarter of young people and almost a fifth of older adults, were not referred for psychiatric treatment or provided with appropriate assessment in the emergency department.
Orygen Senior Research Fellow and the study's lead author, Dr Katrina Witt, said comprehensive psychosocial assessment following self-harm is associated with reduced risk of repeat episodes of self-harm and suicide.
“We know these kinds of assessments can lead to discussion of available treatments and can improve the appropriateness of follow-up care provided to people seeking care after discharge,” Dr Witt said.
“Hospital-treated self-harm has become a growing public health concern, and rates appear to be increasing, particularly in young females.
“For people who have self-harmed, the first few months after discharge from the emergency department is a peak risk period for repeat self-harm and suicide, so providing psychosocial support over this period is crucial if we want to reduce self-harm and suicide rates in our community.”
Guidelines in Australia recommend that every person should receive a psychosocial assessment after every episode of self-harm, but the study found that only around two-thirds of people received this care.
“The failure to provide these assessments in an appropriate and timely manner represents a missed opportunity for self-harm and suicide prevention,” Dr Witt added.
“The findings are an urgent call to action for policymakers, healthcare providers, and mental health professionals to address this issue and prioritise improved mental health care for people who present to hospital for self-harm.”
Psychosocial assessments should thoroughly review a patient's mental health and social needs, the circumstances preceding the self-harm episode and their access to support to manage any ongoing or future urges to engage in self-harm.
“Currently, only around half of hospital doctors and a quarter of nurses report receiving training in providing psychosocial assessments for self-harm,” Dr Witt said.
“Although we’re seeing some improvement in the provision of these assessments, there is still an opportunity to train more healthcare professionals to provide this support to patients and reduce the risk that people – particularly young people – will experience further episodes of self-harm.”