Document Detail


Patient characteristics and behaviours associated with self-harm and attempted suicide in acute psychiatric wards.
MedLine Citation:
PMID:  22512008     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
AIMS AND OBJECTIVES: The study examined events before and after incidents of self-harm and attempted suicide and the characteristics of patients who engage in these behaviours.
BACKGROUND: Psychiatric inpatient populations have an elevated risk of self-harm and suicide, but relatively little is known about the circumstances of these events during an admission.
DESIGN: Retrospective case note analysis.
METHOD: Data were collected on conflict (aggression, rule breaking, etc.) and containment (coerced medication, restraint, etc.) during the first two weeks of admission for a sample of 522 acute psychiatric inpatients.
RESULTS: One in 10 patients self-harmed, and 4% attempted suicide. Aggression, attempting to leave the ward without permission and medication refusal were frequent precursors to incidents. Pro re nata medication and de-escalation were the most frequent interventions to follow an incident. Self-harm and attempted suicides during the current admission were significantly associated with younger age and a history of self-harm.
CONCLUSIONS: A minority of the sample were involved in these behaviours, but incidents occurred soon after admission and sometimes repeatedly during the course of a day. Assessment of risk should be completed as early as possible.
RELEVANCE TO CLINICAL PRACTICE: At-risk patients should be monitored for signs of withdrawal from ward activity, wanting to leave the ward without permission or non-compliance with medication to enable early intervention.
Authors:
Duncan Stewart; Jamie Ross; Charlotte Watson; Karen James; Len Bowers
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of clinical nursing     Volume:  21     ISSN:  1365-2702     ISO Abbreviation:  J Clin Nurs     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-04-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9207302     Medline TA:  J Clin Nurs     Country:  England    
Other Details:
Languages:  eng     Pagination:  1004-13     Citation Subset:  N    
Affiliation:
Health Service and Population Research, Institute of Psychiatry, Kings College London, London, UK. duncan.stewart@kcl.ac.uk
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