Citation

Kuehl S, Nelson K, Collings S. N. Zeal. Med. J. 2012; 125(1367): 70-79.

Affiliation

Social Psychiatry and Population Mental Health Research Unit, University of Otago Wellington, PO Box 7343, Wellington South, Wellington 6024, New Zealand. silke.kuehl@otago.ac.nz.

Copyright

(Copyright © 2012, New Zealand Medical Association)

DOI

unavailable

PMID

23321885

Abstract

AIM: To describe the number, characteristics and management of patients who presented to an emergency department (ED) with intentional self-harm and then re-presented for any reason within 1 week, over a 1-year period. METHOD: A retrospective records review from one New Zealand ED over 12 months. RESULTS: Of the 120 patients who attended the ED more than once with intentional self-harm, 48 re-presented on 73 occasions within 7 days of the index presentation. Of the re-presentations, 55% occurred within 1 day. Mental health assessments by emergency department staff were minimal; challenging incidents occurred in 40% of presentations; and there was an increase in the inpatient admission rate for second presentations. CONCLUSION: We identified a small group of patients who rapidly re-present to the ED following intentional self-harm. The reasons behind those re-presentations could include limited mental health assessments in ED and inadequate follow-up on discharge. System improvements in the ED including better collaboration with mental health services could improve how services address the needs of patients who present with intentional self-harm and reduce costs.

Language: en