Managing self-harm in the emergency department

When someone presents to the emergency department after self-harm, emergency department staff should do the following.

1. Quickly assess risk and emotional, mental and physical state.

2. Try to encourage people to stay and organise a psychosocial assessment for them.

The following is a list of key priorities for implementation, summarised from the self-harm clinical guidelines.

• respect, understanding and choice
• staff training
• activated charcoal
• triage
• treatment
• assessment of needs
• assessment of risk
• psychological, psychosocial and pharmacological interventions.

In the below video, Professor Nav Kapur talks about the best way to help people who attend the emergency department after self-harm, and different types of intervention that might have the potential to help people to reduce or stop their self-harm behaviour. You can also view a transcript (PDF).

Self-harm as a public health outcome

The Public Health Outcomes Framework (PDF) has identified self-harm as a public health indicator.

This means all hospitals nationally are required to record the number of emergency department attendances for self-harm. In the future, this may also include the proportion receiving a psychosocial assessment.

You can also see local area outcome data on self-harm and other health and wellbeing indicators on the Public Health England website.