No harm done? Psychological assessment in the A&E department of patients who deliberately harm themselves.

OBJECTIVE

To determine whether psychosocial assessments of patients presenting to the Accident and Emergency (A&E) Department at Addenbrooke's Hospital, Cambridge, with deliberate self-harm are recorded adequately in the case notes, using the criteria of the 1994 Royal College of Psychiatrists' consensus statement on managing adult deliberate self-harm in hospital.

DESIGN

A cross-sectional study of case notes.

SUBJECTS

A total of 338 patients (accounting for 404 episodes of deliberate self-harm) who presented consecutively between 1 January and 30 June 1996.

RESULTS

56% of episodes resulted in admission to a general hospital bed. In only 11% of conscious patients were adequate psychological assessments recorded in the case notes. Little psychosocial information was recorded in the notes of those patients discharged without follow-up from accident and emergency.

CONCLUSIONS

In the A&E department of this teaching hospital, there is inadequate recording of important psychological information in the case notes of patients who present with deliberate self-harm.