Integrated care pathway for self-harm: our way forward

Emerg Med J. 2010 Jul;27(7):544-6. doi: 10.1136/emj.2009.074054.

Abstract

Background: Balancing pressures of the 4-h wait in Accident and Emergency (A&E) and the National Institute for Clinical Excellence (NICE) requirement for a psychosocial assessment (PSA) before leaving hospital for patients presenting with self-harm is a challenge. This paper suggests a new method for coping with this demand.

Methods: A score of 5 or above on the Modified Sad Persons Scale (MSPS), rated by general hospital staff, would result in an automatic admission to the general hospital for detailed PSA by the dedicated liaison psychiatry team the following day.

Results: Most patients are usually admitted due to medical concerns. Only a small number of patients needed further psychiatric inpatient admission.

Conclusions: This integrated care pathway (ICP) is evidence of true multidisciplinary working resulting in mutually beneficial outcomes for both the acute and mental health trusts.

MeSH terms

  • Critical Pathways*
  • Delivery of Health Care, Integrated / statistics & numerical data*
  • England
  • Humans
  • Medical Staff, Hospital
  • Mood Disorders / diagnosis
  • Outcome Assessment, Health Care
  • Patient Admission
  • Patient Care Team*
  • Psychiatric Status Rating Scales
  • Self-Injurious Behavior / psychology*