Self-Harm: The Short-Term Physical and Psychological Management and Secondary Prevention of Self-Harm in Primary and Secondary Care
National Collaborating Centre for Mental Health (NCCMH)
This evidence-based clinical guideline commissioned by the
National Institute for Health and Clinical Excellence (NICE)
presents guidance on the short-term physical and psychosocial
management of self-harm. Comprehensive information about self-harm
(including prevalence and risk factors) and a review of service
user experience are included. A milestone in the development of
truly independent and transparent clinical guidance, this book is
an essential resource for all professionals involved in the
management of self-harm and an indispensable tool for improving the
quality of services for people who self-harm in England and
Wales.
NICE Mental Health Guidelines
These guidelines from NICE set out clear
recommendations, based on the best available evidence, for health
care professionals on how to work with and implement physical,
psychological and service-level interventions for people with
various mental health conditions.
The book contains the full guidelines
that cannot be obtained in print anywhere else. It brings together
all of the evidence that led to the recommendations made, detailed
explanations of the methodology behind their preparation, plus an
overview of the condition covering detection, diagnosis and
assessment, and the full range of treatment and care
approaches.
The accompanying CD-ROM contains all the data used as evidence,
including:
- Included and excluded studies.
- Profile tables that summarise both the quality of the evidence
and the results of the evidence synthesis.
- All meta-analytical data, presented as forest plots.
- Detailed information about how to use and interpret forest
plots.
Full Contents
Guideline Development Group Membership
1. Introduction
- National guidelines.
- The national self-harm guideline.
2. Introduction to
self-harm
- What is self-harm and what does the guideline
cover?
- A note about terminology.
- Why do people self-harm?
- Methods of self-harm.
- How common is self-harm?
- Factors that are associated with
self-harm.
- Special groups.
- The consequences of self-harm.
- Contact with services.
- How people who self-harm experience
services.
- Assessment and treatment for people who
self-harm.
- The prevention of self-harm.
- Research recommendations.
3. Methods used to develop this
guideline
- Overview.
- The Guideline Development Group.
- Clinical questions.
- Systematic clinical literature review.
- Stakeholder contributions.
- Validation of this guideline.
4. Recommendations
- Issues for all services and healthcare
professionals.
- The management of self-harm in primary
care.
- The assessment and initial management of
self-harm by ambulance services.
- The treatment and management of self-harm in
emergency departments.
- Medical and surgical management of self-harm.
Support and advice for people who repeatedly self-harm.
- Psychosocial assessment.
- Referral, admission and discharge following
self-harm.
- Special issues for children and young people
(under 16 years).
- Special issues for older people (older than
65 years).
- Psychological, psychosocial and
pharmacological interventions.
- Research recommendations.
5. Service user experience of
services
- Introduction.
- Methods.
- Findings.
- Health professionals' attitudes to
self-harm.
- Clinical practice recommendations.
- Research recommendations.
6. Consent
- Introduction.
- Mental capacity.
- Advance directives.
- Who should assess capacity?
- The role of the Mental Health Act.
- Intoxication.
- Young people.
- Putting these principles into practice.
- Clinical practice recommendations.
- Research recommendations.
7. The medical and surgical care of
people who have self-harmed
- Introduction.
- The management of self-harm in primary
care.
- The management of self-harm by ambulance
staff.
- Information and laboratory services available
to clinicians treating self-poisoning.
- The role of triage in the management of
self-harm in emergency departments.
- Routine screening for plasma paracetamol
concentrations.
- The treatment and management of
self-poisoning by gut decontamination.
- Treatment and management of poisoning with
salicylates.
- Treatment and management of paracetamol
overdose.
- The use of flumazenil in the treatment and
management of benzodiazepine overdose.
- Treatment and management of opioid
overdose.
- The treatment and management of superficial
wounds.
- Post-care services and information.
8. Psychosocial assessment after
hospital attendance for self-harm
- Introduction.
- Literature review.
- The assessment of need.
- The assessment of risk.
- Integrating risk and needs assessment.
- Who should undertake assessments?
- Clinical summary.
- Clinical practice recommendations.
- Research recommendations.
9. Psychological, pharmacological and
psychosocial interventions for the management of
self-harm
- Introduction.
- Current clinical practice.
- Studies included.
- Comparisons made.
- Psychological interventions.
- Pharmacological interventions.
- Psychosocial and other interventions.
- Clinical summary.
- Clinical practice recommendations.
- Research recommendations.
10. References.
11. Glossary
12. Abbreviations
13. Appendices.