Researchers from The University of Manchester found 40% of those attending hospital after an overdose or other self-injury did not get a specialist psychosocial assessment.
The treatment patients received also varied according to where they lived – suggesting a postcode lottery was still in operation.
The researchers looked at 6442 individuals who presented at 32 hospitals with 7689 episodes of self-harm over a three-month period and investigated how people were treated and followed up. They also measured the quality of self-harm services using a 21-item measure. The team compared their results with an earlier survey carried out in 2001.
Dr Jayne Cooper, from the University’s Centre for Suicide Prevention who led the study, said: “Hospitals varied markedly in their management of self-harm. The proportion of episodes that received a psychosocial assessment in line with national guidance varied from 22% in some hospitals to 88% in others. Overall we found the level of assessment had remained more or less static over the last 10 years.”
But the study did show some evidence that the quality of health services for patients who self-harmed may have improved, she added.
The study, funded by the National Institute for Health Research (NIHR) and published in BMJ Open today (Wednesday 20 November), provides the most detailed information on services for self-harm available nationally.
Professor Nav Kapur, senior author for the study and chair of the recent National Institute for Health and Care Excellence (NICE) self-harm guideline, said: “We were surprised to find that despite national guidelines and policy initiatives, the management of self-harm in English hospitals is as variable as ever. This is important because the treatment patients get in hospital affects their outcome.
Professor Kapur, who is also an Honorary Consultant in Psychiatry at Manchester Mental Health and Social Care Trust, added: “It remains to be seen how the more recent guidance and the linked quality standards for self-harm services will impact on care. Hopefully, people who self-harm will increasingly get the assessment and treatment they need.”
The researchers are both part of the University’s Centre for Suicide Prevention based in the Centre for Mental Health and Risk one of the leading centres for research into suicidal behaviour internationally.
Notes for editors
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The study was published in BMJ Open on Wednesday 20 November.
National Institute for Health Research (NIHR)
The National Institute for Health Research (NIHR) is funded by the Department of Health to improve the health and wealth of the nation through research. Since its establishment in April 2006, the NIHR has transformed research in the NHS. It has increased the volume of applied health research for the benefit of patients and the public, driven faster translation of basic science discoveries into tangible benefits for patients and the economy, and developed and supported the people who conduct and contribute to applied health research. The NIHR plays a key role in the Government’s strategy for economic growth, attracting investment by the life-sciences industries through its world-class infrastructure for health research. Together, the NIHR people, programmes, centres of excellence and systems represent the most integrated health research system in the world. For further information, visit the NIHR website (www.nihr.ac.uk).
This paper presents independent research funded by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research Programme (Grant Reference Number RP-PG-0606-1247).The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.