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Deliberate Self-harm.

You have been treated for your self harm injuries. The following information will help you and your family and friends in this emotionally charged time.

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Self-harm

Self-harm is a very common problem.

It accounts for over 170,000 attendances to Emergency Departments (ED) in Britain every year.

People commonly self-harm by cutting themselves, taking overdoses or injuring themselves in other ways.

People often do not intend to kill themselves. They may harm themselves to release tension or to express their distress to others.

Feelings often felt after self-harming include guilt, embarrassment, shame and regret.

This leaflet will provide you with information about what you may expect during your care process. If there is anything you do not understand, please ask the doctor or nurse that is looking after you.

Urgent Care Centre (UCC)

On arrival in the UCC a trained nurse will assess you. You will be treated with care and respect and will be offered an environment that is safe and supportive to minimise your distress. In order to help you the nurse will need to ask you some questions related to your self-harm, to determine your clinical priority and to ensure that you will be seen in a timely manner.

During your initial assessment the following procedures may be performed:

Observations including temperature, pulse, blood pressure and respiratory rate
Electrocardiograph (ECG), a painless procedure recording the electrical activity of your heart
Collection of samples from you for analysis, usually this will be a sample of blood, although samples of urine, vomit or sometimes gastric contents may be indicated

If you have ingested a substance we will access TOXBASE, a poisons information service, for guidance on how to treat you.

Following this initial assessment a doctor or advanced nurse practitioner will perform a more in-depth physical and mental health assessment and discuss treatment options, dependent on the type of self-harm. The doctor or nurse caring for you will provide full information about the treatment options, and ensure that you have the opportunity to give your informed consent before any procedure.

If you are considering leaving the department before being seen by a healthcare professional, we would like you to tell us, so that we are aware and more importantly to see if we can help you in any other way before leaving.

Treatment of self-poisoning

Self-poisoning can be treated by reducing absorption from the gut, increasing elimination and/or countering the effects of the poison by use of antidotes, depending upon the nature of the poison and the route of intake.

Treatment options may include drinking a solution of charcoal and water, which helps to prevent the absorption of certain ingested substances into the gut. This will be dependent upon the substance and length of time since ingestion.

Treatment of wounds

Wounds that are not too deep or that are uncomplicated can be closed with tissue adhesive ‘glue’, skin closure strips or suturing, whilst more complicated injuries may need surgical assessment and possibly exploration.

You will be offered treatment for the physical consequences of self-harm, regardless of your willingness to accept psychosocial assessment or psychiatric treatment. Painkillers and adequate anaesthetic will be offered to you should injuries require suturing or other painful treatments.

Other treatment

Following your assessment and treatment, the decision about referral for further treatment and help will be based upon a comprehensive mental health assessment, including an assessment of risk by the Mental Health Liaison Team.

If you are under 16 and have self-harmed we would like to admit you to hospital for further assessment by the Child and Adolescent Mental Health Services (CAMHS).

In the future, as an alternative, if you feel you want to self-harm again telephone one of the helplines below, make an appointment with your GP or attend the Urgent Care Centre to speak to someone about your problems.

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