The importance of psychosocial assessment following self-harm 

NICE guidance recommends that a psychosocial assessment should be carried out by a mental health professional as soon as possible after an episode of self-harm. The papers below provide insights into the importance and experience of psychosocial assessment. 

Empathetic care, collaborative assessment and compassion were reported as being beneficial when psychosocial assessments were undertaken following self-harm presentations to the emergency department. Experiencing stigmatising attitudes, long waiting times and perceptions that such assessments were standardised were perceived as unhelpful.  

• ‘Relieved to be seen’- patient and carer experiences of psychosocial assessment in the emergency department following self-harm: qualitative analysis of 102 free-text survey responses (BMJ Open, 2022) 

Patients’ reasons for declining a psychosocial assessment after presenting to hospital following self-harm included long waiting times, previous problematic interactions with staff and organisational reasons for non-assessment such as clinicians not offering assessments. 

• ‘Wasn’t offered one, too poorly to ask for one’ – Reasons why some patients do not receive a psychosocial assessment following self-harm: Qualitative patient and carer survey (Australian & New Zealand Journal of Psychiatry, 2022) 

This study shows that specialist psychosocial assessment may reduce the risk of repeat self-harm. This type of routine care should be provided for all individuals who present to hospital after self-harm, regardless of perceived risk of further self-harm. 

• Routine hospital management of self-harm and risk of further self-harm: propensity score analysis using record-based cohort data (Psychological Medicine, 2018)