A national survey of the hospital services for the management of adult deliberate self-harm

AIMS AND METHOD Services were compared for the management of deliberate self-harm with existing national guidance. A postal survey was sent to all clinical directors of adult psychiatry at all NHS trusts assessing adult patients admitted to general hospital following deliberate self-harm in England. RESULTS Responses were received from 129 (65%) trusts. Thirty per cent of trusts do not use secondary psychiatric services for psycho-social assessment following deliberate self-harm; 52% have designated self-harm liaison staff and 69% of general hospitals have a ward to which most cases of deliberate self-harm are admitted. However, only 18% have staff with psychiatric experience. In 82% of trusts training is provided for junior psychiatrists at induction but in only 56% are observed-assessments undertaken. Forty-two per cent of the trusts have a deliberate self-harm services planning group. CLINICAL IMPLICATIONS Standards for deliberate self-harm services fall substantially below existing national guidelines, particularly in the areas of planning and training.