The Green Card Clinic: Overview of a Brief Patient-Centred Intervention Following Deliberate Self-Harm

Wilhelm, Kay; Finch, Adam; Kotzé, Beth; Arnold, Karen D.; McDonald, Geoff; Sternhell, Peter; Hudson, Beaver

doi:10.1080/10398560601083068

Cited by 22 publications

(34 citation statements)

References 24 publications

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“…Previous studies have suggested that an emphasis on contact and assertive followup (Hvid & Wang, 2009;Wilhelm, Finch, Kotze et al, 2007), home visits by a community nurse (van Heeringen, Jannes, Buylaert et al, 1995), and continuity of care (Moller, 1989) may be of benefit. Furthermore, brief interventions in the form of letters and postcards that facilitate and maintain contact between individuals and services and may have a role to play in the management of suicidal behavior (Carter, Clover, Whyte et al, 2005;Motto & Bostrom, 2001).…”

Section: Interpretation and Implicationsmentioning

confidence: 97%

Assessment Rates and Compliance With Assertive Follow-up After Self-Harm: Cohort Study

Murphy

Steeg

Cooper

et al. 2010

Archives of Suicide Research

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The objectives of this study were to identify 1) the proportion of self-harm episodes that resulted in assessment by a specialist self-harm team and offers, attendance, and completion of brief therapy and 2) the factors associated with these treatment options. A prospective cohort study of 717 hospital presentations of self-harm was conducted. Rates of assessment, offers and completion of therapy ranged from 50% to 60%. Of those offered therapy, 73% attended one or more sessions. Attendance was associated with depressive psychopathology and existing treatment in primary care. These results may reflect some of the challenges of engaging this patient group. We found that receipt of treatment was determined by patient factors. Future studies might also examine the role of service-related or clinician factors.

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Section: Interpretation and Implicationsmentioning

confidence: 97%

Assessment Rates and Compliance With Assertive Follow-up After Self-Harm: Cohort Study

Murphy

Steeg

Cooper

et al. 2010

Archives of Suicide Research

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“…This is important given the reports of increased mortality and morbidity from a range of natural causes (2,3) in people presenting to Emergency Departments with suicidality. It is also important given the association between increased suicidality and poorer lifestyle behaviours that was documented in our earlier study (34).…”

Section: Discussionmentioning

confidence: 83%

“…This study used data collected from patients who attended the GCC at St Vincent's Hospital. The details of the GCC are discussed more fully in previous papers (33)(34)(35). In summary, following presentation to the Emergency Department with suicidal behaviour or ideation, all patients receive routine medical and psychiatric assessments (by an emergency doctor and psychiatry registrar).…”

Section: Methodsmentioning

confidence: 99%

“…The Fantastic Lifestyle Checklist (FLC) (32) was recently found to be a valid tool for measurement of lifestyle behaviours in a sample of patients with suicidal behaviour (33). We have previously reported a significant difference between the overall FLC scores of people presenting with first episode, compared to repeat episodes, of suicidality to the Green Card Clinic (GCC) at St Vincent's Hospital Sydney (34).…”

Section: Introductionmentioning

confidence: 99%

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Is There an Association Between Dietary Habits and Recurrent Deliberate Self-harm?

Berg

Wilhelm

Handley

2019

Preprint

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Purpose Despite increasing awareness of high rates of physical illness and poor lifestyle behaviours among patients with a history of suicidality (suicidal ideation and behaviours), there is little research on specific lifestyle factors that are potentially problematic for this group. This paper aims to explore the relationship between frequency of deliberate self-harm and certain lifestyle factors, including balanced meals, eating breakfast, consumption of 'unhealthy' food, weight, exercise, substance and alcohol use, smoking and social support, in a cohort of patients who present to the Emergency Department (ED) with suicidality. Methods From 2007-2016, data from lifestyle and mental health measures were collected from 448 attenders at an outpatient clinic for suicidal behaviour following an ED presentation. Lifestyle behaviours (from Fantastic Lifestyle Checklist) and mental health (from Depression and Anxiety Stress Scale, clinical diagnosis and number of previous deliberate self-harm episodes) were measured on arrival. The associations between lifestyle variables and mental health outcome measures were examined. Results Gender, age, depression symptoms, poor diet, and smoking were all associated with a higher average number of DSH episodes. There were nonsignificant positive trends between all the other poor lifestyle behaviours and deliberate self-harm. There was no association between deliberate self-harm episodes and diagnosis of depression or anxiety disorder. In a multiple linear regression model the only factors that remained significant were age, smoking and eating balanced meals. Conclusion In this sample of patients with suicidal behaviour, balanced meals and smoking were the lifestyle behaviours that were found to have the strongest independent association with repeated deliberate self-harm. We suggest that asking two simple questions about current smoking and balanced meals has the potential to direct the focus on modifiable lifestyle behaviours with important long term implications for individuals and public health implications for the group of people presenting with suicidality.

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“…Table 1. Clinical pathways identified in the literature and assessed against the criteria of Kinsman et al 15 The first five pathways [25][26][27][28][29] were developed by British National Health Service (NHS) Trusts as a result of local clinical practice guidelines. The criteria of Kinsman et al 15 Ò Ò Ò Ò Ò Designed for young people in the local area, stops at the ED but gives some post-discharge resources Nurse-led pathway 30 Ò Ò Ò Ò Ò Ò Description of care pathway to provide a 'fast track' through the ED Hunter Area model for management of selfpoisoning 18 Ò Ò Ò Ò Ò Care pathway covers all age groups but is only for self-poisoning, not other forms of deliberate self-harm or suicidality more generally A Pathways specifically for children and young people.…”

Section: Where To Next?mentioning

confidence: 99%

Clinical pathways for suicidality in emergency settings: a public health priority

Wilhelm

Korczak²,

Tietze

et al. 2017

Aust. Health Review

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Abstract.Rates of self-harm in Australia are increasing and constitute a concerning public health issue. Although there are standard treatment pathways for physical complaints, such as headache, abdominal pain and chest pain, in Emergency Medicine, there is no national pathway for self-harm or other psychiatric conditions that present to the emergency department. Herein we outline the difference between clinical practice guidelines and clinical pathways, discuss pathways we have identified on self-harm in Australia and overseas and discuss their applicability to the Australian context and the next steps forward in addressing this public health issue.Additional keyword: emergency department.

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The Green Card Clinic: Overview of a Brief Patient-Centred Intervention Following Deliberate Self-Harm

Cited by 22 publications

References 24 publications

Assessment Rates and Compliance With Assertive Follow-up After Self-Harm: Cohort Study

Assessment Rates and Compliance With Assertive Follow-up After Self-Harm: Cohort Study

Is There an Association Between Dietary Habits and Recurrent Deliberate Self-harm?

Clinical pathways for suicidality in emergency settings: a public health priority

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