MANCHESTER, England, Aug. 13 (UPI) -- A new study on treatment and discharge of emergency room patients with self-harm injuries found that hospitals in England correctly used the most intensive treatments for patients who needed them the most, but that additional intervention after discharge may help to save additional lives.
"Hospitals have a number of strategies to use when people attend with self-harm, but no one has looked at the association of these with mortality risk on a large scale before," said Nav Kapur, a professor at the University of Manchester, in a press release. "We need to be clear that these findings indicating higher risk of death do not mean these treatments are harmful -- instead it looks like health services are reserving the most intensive treatments for the patients at greatest need."
Using data from five hospital emergency rooms in England collected between 2000 and 2010, researchers reviewed the records for 38,415 patients who presented with self-harm. In the 12 months after they went to the ER, 261 people died because of suicide and 832 died from any cause.
Researchers were able to account for characteristics of people, their history of self-harm, and the types of treatment they received at the hospital. In cases of men over age 65 and where patients had a history of self-harm, psychiatric admission may have had an effect at reducing deaths.
The authors cautioned in the study, published in The Lancet: Psychiatry, a lack of information on whether patients followed up when referred for further treatment and changes in treatment procedures over the study period limited knowledge what happened when patients left the hospital.
A related commentary also published in The Lancet: Psychiatry, suggests attention to general need, a specific post-discharge plan with follow-up from the hospital, and checking the involvement of family and friends for social support could help to reduce the number of post-discharge deaths.
"Clearly we need to do more to find out what works following self-harm and how it works. Attendance at hospital represents an opportunity for services to address underlying issues such as mental health problems, difficult life circumstances, and alcohol use which contribute to self-harm," Kapur said. "Our research suggests routine aspects of care can be really helpful -- doing the simple things well could improve services for patients and may ultimately reduce the number of deaths."
