Service users’ experiences of emergency care following an episode of self-harm: a mixed evidence synthesis

Scarth, Bonnie; Pavlova, Alina; Hetrick, Sarah; Witt, Katrina; Hawton, Keith; Fortune, Sarah

doi:10.1002/14651858.cd014940

Cited by 2 publications

(2 citation statements)

References 109 publications

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“…The research question and priority is part of a broader programme of work in which the voice of those with living or lived experience of suicidal distress is central and based on active collaboration with lived experience academics. This study connects with systematic reviews by this group on service user experiences of SH37 and staff attitudes towards those seeking hospital care after SH 38…”

Section: Public and Patient Participationmentioning

confidence: 72%

Multisite sentinel surveillance of self-harm in New Zealand: protocol for an observational study

et al. 2022

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IntroductionNew Zealand (NZ) has a persistently high rate of suicide, particularly among young people. Hospital presentation for self-harm (SH) is one of the strongest predictors of death by suicide. Improving the monitoring of SH and suicide is a key recommendation for suicide prevention by WHO. This study will establish the first ever sentinel surveillance for SH at several large hospitals and a monthly survey of all practicing paediatricians in NZ. The study will provide robust information about the epidemiology of SH, factors associated with SH and the types of interventions required for those presenting to hospital with SH.Method and analysisThis observational study will establish SH surveillance in the emergency departments of three public hospitals for the first time in NZ, where study population will include individuals of all ages who present with SH or suicidal ideation. The study methodology is in line with the WHO Best Practice guidelines and international collaborators in Australia and Europe. Electronic triage records will be reviewed manually by the research team to identify potential cases that meet inclusion criteria. For all eligible cases, variables of interest will be extracted from routine clinical records by the research team and recorded on a secure web-based survey application. Additionally, SH surveillance data for the national paediatric population (<15 years) will be obtained via the New Zealand Paediatric Surveillance Unit (NZPSU); paediatricians will report on included cases using the same variables using a secure survey application. A deidentified dataset will be produced for aggregated statistical analysis.Ethics and disseminationThe University of Otago Health Ethics Committee granted ethical approval for this study in addition to local ethics approval at participating hospital sites. The study findings will be disseminated to relevant stakeholders in NZ, in addition to international audiences through publications in peer-reviewed scientific journals and conference presentations.

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Section: Public and Patient Participationmentioning

confidence: 72%

Multisite sentinel surveillance of self-harm in New Zealand: protocol for an observational study

et al. 2022

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“…Research and clinical experience suggest that front-line staff, those with lived experience and their whānau all have suggestions for how things could be improved (Fortune et al, 2021; Scarth et al, 2021). The context in which a risk assessment is conducted and the process of conducting a risk assessment are both likely to have a significant impact on both the person being assessed and the assessor, for example, the type of information a person may choose to share.…”

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confidence: 99%

Suicide risk assessments: Why are we still relying on these a decade after the evidence showed they perform poorly?

Fortune

Hetrick

2022

Aust N Z J Psychiatry

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Suicide deaths have a profound impact on whānau and community and are a tragic loss. However, from a statistical point of view, suicide is a relatively rare event. Predicting rare events is difficult, and the implications for suicide prevention were highlighted in an important editorial in this journal more than a decade ago, yet little seems to have changed. Risk assessment that focuses on accurate prediction of suicide in real-world contexts is given a great deal of attention in mental health services, despite the fact that current scientific knowledge and best practice guidelines in this area highlight that it is unlikely to be a good basis on which to provide access to treatment. It is our view that we have a good enough understanding of the common conditions people who struggle with suicidal distress experience and energy is better directed at acting to reduce exposure to these conditions and providing treatment for those who seek it. Blueprints for successful suicide prevention exist. If we lessen the focus on prediction, we will have greater resources to focus on treatment and prevention.

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Service users’ experiences of emergency care following an episode of self-harm: a mixed evidence synthesis

Cited by 2 publications

References 109 publications

Multisite sentinel surveillance of self-harm in New Zealand: protocol for an observational study

Multisite sentinel surveillance of self-harm in New Zealand: protocol for an observational study

Suicide risk assessments: Why are we still relying on these a decade after the evidence showed they perform poorly?

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