A & E

New Guidelines to Standardise Care for People Who Self Harm.

The National Institute for Clinical Excellence (NICE) have issued new guidelines to standardise care for people who self harm in England and Wales.

Firstly, the new guideline makes recommendations for the physical, psychological and social assessment and treatment to be offered to people in the first 48 hours after a self harming incident. This covers all acts of self harm.

• Everyone who it is believed to have self harmed, should be offered a preliminary psycho-social assessment when at the triage stage.
• Proper care of a physical injury should not reflect a patients willingness to undergo psycho-social assessment or psychiatric treatment.
• Self harmers should receive the same care, dignity, respect and privacy as is offered to any other patient. Healthcare professionals should be supportive and take into account the distress of the self harm patient, over and above the nature of the injury.
• Accident and Emergency departments should have activated charcoal available at all times for self harm patients who have self-poisoned or overdosed.
• Always use proper anaesthesia and/or analgesia if treatment for self injury is painful.
• All staff who come into contact with people who self harm should receive appropriate training.
• All people who have self harmed should be assessed for future risk of self harm or suicide.
• Health professionals should take account of emotional distress as well as physical distress.
• Medical staff should not delay treatment because it is self inflicted.
• Acts of self harm by the elderly should be regarded as evidence of suicidal intent until proven otherwise.
• The key phychological characteristics associated with risk, in particular, depression, hopelessness and continuing suicidal intent, should be identified.

Dr Tim Kendall, a consultant psychiatrist and co-director of the National Collaborating Centre for Mental Health, is reported to have said: "Self harm and suicide have now become the third leading cause for life years lost after cancer and heart disease in all age groups. Few people providing care in casualty understand why people self harm and don't know how to help them effectively.

"Hopefully, this statement won't be true for much longer!

[taken from: Distant Healer.Co.UK]