One-third of accident and emergency (A & E) patients who deliberately take an overdose are not admitted to hospital, and this proportion is increasing. We conducted an audit of 300 case records of such patients from two different district health authorities in London. We found that only 4% of patients were assessed in the manner recommended by the Department of Health and 10% had no psychosocial assessment whatsoever. We recommend specific training, an assessment form, regular audit, and communication with the general practitioner.
Secretary of State for Health. The Health Of the Nation: A Strategy for Health in England. London: HMSO, 1992.
2.
NordentoftMBreumLKNordestgaardAGHundingABjaeldagerPAL. High mortality by natural and unnatural causes: a 10 year follow up study of patients admitted to a poisoning treatment centre after suicide attempts. BMJ1993;306:1637–41.
3.
OwensDWJonesSJ. The accident and emergency department management of deliberate self-poisoning. Br J Psychiatry1988;152:830–3.
4.
Department of Health and Social Security. Guidance On the Management Of Deliberate Self-harm. Health Notice 84 (25). London: DHSS, 1984.
5.
BlackDCreedF. Assessment of self-poisoning patients by psychiatrists and junior medical staff. J R Soc Med1988;81:97–9.
6.
OwensD. Self-harm patients not admitted to hospital. J R Coll Physicians (Lond)1990;24:281–3.
7.
GardnerRHankaRRobertsSJAllon-SmithJMKingsAANicholsonR. Psychological and social evaluation in cases of deliberate self-poisoning seen in an accident department. BMJ1982;i:491–3.
8.
BlackerCVRJenkinsRSilverstoneT. Assessment of deliberate self-harm on medical wards. Psychiatr Bull1992;16:262–3.
9.
HawtonKFaggJPlattSHawkinsM. Factors associated with suicide after parasuicide in young people. BMJ1993;306:1641–4.
