Understanding self-harm in young people aged 12-24 in Southwark, an inner city London borough: a mixed methods study.
PHE ePoster Library. Shah N. Sep 12, 2019; 274359; 165
Dr. Neha Shah
Dr. Neha Shah
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Abstract
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Abstract Introduction
Psychological interventions are the mainstay of self-harm management despite limited evidence of effectiveness. In response to the emerging evidence base regarding impacts of adverse childhood experiences; a mixed methods study was carried out to better understand social factors relating to self-harm in young people and to inform population-based action.
Method
Data on risk factors, presentation and management was collected from psychiatric assessment notes of 100 young people aged 12-24 presenting to A&E with self-harm in 2015-2016. Quantitative data was integrated with qualitative data from focus groups with frontline professionals and young people, to explain trends and expand knowledge of system management.
Results
63% of cases were previously known to mental health, primary care or school services and 79% were coded as having a mental disorder. 65% had history of adverse childhood experience or other trauma, and 33% reported both co-occurring. 28% had history of substance misuse and 20% were not in education, employment or training. Key identified triggers were relationship difficulties (20%) and school or work pressures (19%). Focus groups highlighted breakdown of close relationships as a fundamental risk. A&E attendance prompted discharge to mental health service in 56% of cases. Community professionals expressed lack of confidence and clarity in how, when and where to refer for further support.
Conclusion
The study has highlighted the importance of family, education and employment settings to prevention and management of self-harm; and demonstrated need for a clear care pathway that addresses the spectrum of low to high risk presentations. External funding details CP is funded by a Wellcome Trust Research Training Fellowship. This paper represents independent research part funded by the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London.
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