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Improving emergency care for teenagers who self-harm

Improving emergency care for teenagers who self-harm

Dominic Jones, Research Co-ordinator at the Royal Berkshire NHS Foundation Trust, explains research into improving care for young people coming to the emergency department for self-harm. 

Adolescent mental health is one of the big issues facing healthcare in this country.  It is estimated that half of those with mental health problems in their lifetime show symptoms before the age of 14 and that one in ten young people have a mental health problem. 

Engaging in deliberate self-harm is more common in those with mental health difficulties, which can require a trip to the hospital to treat. Admissions for self-harm at emergency departments (ED) nationwide are increasing amongst the adolescent population and of major concern is the 20 percent ED re-attendance rate, a ‘revolving door’ of care where injuries are treated but adequate aftercare is not routinely being offered or taken up by patients. 

Current research investigating self-harm amongst adolescents focuses on causes and treatments. Some studies have investigated the experiences of young people who attend ED following self-harm and tend to support the notion that the experience is negative for them, which may increase the likelihood of re-admittance. Where research is lacking is into the reasons why young people feel they have had negative experiences in the ED and whether aspects of their personalities influence how they perceive the care they receive.  

The Finding Voices study is a research project run in collaboration between the Royal Berkshire Hospital and University of Reading. The study involves recruiting 200 patients aged 12 to 18 attending ED for a self-harm injury or a suspected fracture, to compare the two. Those eligible and their parents will be asked to complete a questionnaire 30 minutes after arrival, examining their expectations of the ED, personality and attachment styles. A second questionnaire completed just before departure examines what they experienced in ED and includes specific questions on what they would have liked from the service, such as ‘would you have liked more information on the reasons young people harm themselves?’ 

Data collection is underway and it is hoped that with this information, the ED service will be in a better position to address increased re-admittance rates and improve the ED experience for these young people through staff training and changes in working practices.