Care of children and young people

Published Date: 19th July 2016

Publication Authors: Aziz M, Bentur H

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Background and aim 

Deliberate Self-harm (DSH) affects 1 in 15 young people and remains one of top 5 causes of acute hospital admissions in UK. We looked at children attending hospital with DSH to assess their pathways of care and discharge outcomes. We also looked to see if any trends emerged in their attendance to hospital.

Methods 

Retrospective review of patients over 6 month’s period from March to August 2012.

Results 

135-patients were identified, 124 with diagnosis of self-harm and 11 with previous mental health problems. Following their attendance to emergency department 90% (n122) needed inpatient assessment and 96% of these were followed-up by mental health team. Average length of stay was 3 h to 6 days. Thoughts of harm included 81% (n100), drug overdose 50% (n62) and physical injury 37% (n46). Analgesics were most common drug overdose in 26% (n29) and medical interventions was needed in 19% (n12). 61% (n83) were girls. Social factors like parental-separation was seen in 61% (n82), living in supported accommodation in 26% (n35), family history of mental illness in 23% (n31) and social-services involved in 38% (n52).

Conclusion 

We found that most of our patients had significant DSH needing inpatient management (5% of our admissions) and majority needed follow-up with mental health services which reinforces the need to work closely with mental health team. Social risk factors were commonly found in our cohort. Recognition and early intervention may reduce the incidence of self-harm in these children. Analgesics were the most common drug of overdose reflecting the easy availability of these to children.

Wajid, L; Aziz, M; Bentur, H. (2014).  Care of children and young people with deliberate self-harm:Are we doing it right?  Archives of Disease in Childhood. 99 (Suppl 2), A569.

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