Access the full text.
Sign up today, get DeepDyve free for 14 days.
Joseph Smith, Alessandro Nadai, E. Storch, B. Langland‐Orban, Etienne Pracht, J. Petrila (2016)
Correlates of Length of Stay and Boarding in Florida Emergency Departments for Patients With Psychiatric Diagnoses.Psychiatric services, 67 11
(2019)
Clinically-led Review of NHS Standards. Interim Report from the NHS National Medical Director
M. Conlon, Claire O'Tuathail (2012)
Measuring emergency department nurses' attitudes towards deliberate self-harm using the Self-Harm Antipathy Scale.International emergency nursing, 20 1
(2007)
Mental Health Policy Implementation Guide: Liaison Psychiatry and psychological medicine in the General Hospital
D. Clarke, D. Dusome, Linda Hughes (2007)
Emergency department from the mental health client's perspective.International journal of mental health nursing, 16 2
(2015)
What’s behind the A&E ‘crisis’? Policy Briefing #3
Jakqui Barnfield, W. Cross, K. Mccauley (2018)
Therapeutic optimism and attitudes among medical and surgical nurses towards attempted suicide.International journal of mental health nursing, 27 6
(2016)
Achieving better access to 24/7 urgent and emergency mental health care – Part 2: implementing the evidence-based treatment pathway for urgent and emergency liaison mental health services for adults and older adults
M. Parsonage, C. Tutty (2012)
Liaison psychiatry in the modern NHS
I. Pope, Helen Burn, S. Ismail, T. Harris, D. McCoy (2017)
A qualitative study exploring the factors influencing admission to hospital from the emergency departmentBMJ Open, 7
(2015)
Exploring disparities in hospital use for physical healthcare. Research summary. QualityWatch. The Health Foundation
U. Shaikh, Iqra Qamar, Farhana Jafry, Mudasar Hassan, Shanila Shagufta, Yassar Odhejo, Saeed Ahmed (2017)
Patients with Borderline Personality Disorder in Emergency DepartmentsFrontiers in Psychiatry, 8
(2019)
Clinically-led review of NHS standards
K. Saunders, K. Hawton, S. Fortune, Suhanthini Farrell (2012)
Attitudes and knowledge of clinical staff regarding people who self-harm: a systematic review.Journal of affective disorders, 139 3
(2014)
Model Service Specifications for Liaison Psychiatry Services – Guidance. 1 edition. Strategic Clinical Network for Mental Health, Dementia and Neurological Conditions
R. Carroll, P. Corcoran, E. Griffin, I. Perry, E. Arensman, D. Gunnell, C. Metcalfe (2016)
Variation between hospitals in inpatient admission practices for self-harm patients and its impact on repeat presentationSocial Psychiatry and Psychiatric Epidemiology, 51
J. Freeman, S. Croft, S. Cross, C. Yap, S. Mason (2010)
The impact of the 4 h target on patient care and outcomes in the Emergency Department: an analysis of hospital incidence dataEmergency Medicine Journal, 27
D. Swancutt, Sian Joel-Edgar, M. Allen, Daniel Thomas, H. Brant, J. Benger, R. Byng, J. Pinkney (2017)
Not all waits are equal: an exploratory investigation of emergency care patient pathwaysBMC Health Services Research, 17
P. Karman, N. Kool, I. Poslawsky, B.K.G. Meijel (2015)
Nurses' attitudes towards self-harm: a literature review.Journal of psychiatric and mental health nursing, 22 1
T. Bastiampillai, Geoffrey Schrader, R. Dhillon, Jörg Strobel, N. Bidargaddi (2012)
Impact of a psychiatric unit’s daily discharge rates on emergency department flowAustralasian Psychiatry, 20
British Medical Journal Open, 7
S. Mcghee, A. Finnegan, N. Angus, J. Clochesy (2019)
Responding to nerve agent poisoning: a guide for emergency nurses. Part 2.Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association
J. Lloyd-Rees (2018)
Supporting frequent attenders to reduce their visits to an emergency department.Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association
Edward Tyrrell, D. Kendrick, K. Sayal, E. Orton (2018)
Poisoning substances taken by young people: a population-based cohort studyThe British Journal of General Practice, 68
(2018)
Self-harm and Suicide Prevention Competence Framework: Adults and Older Adults
Department for Communities and Local Government (2015) The English Indices of Deprivation 2015: statistical release
(2012)
Preventing suicide in England: A cross-government outcomes strategy to save lives
G. Rayner, Joanna Blackburn, K. Edward, J. Stephenson, K. Ousey (2018)
Emergency department nurse's attitudes towards patients who self‐harm: A meta‐analysisInternational Journal of Mental Health Nursing, 28
D. Mullins, S. Machale, D. Cotter (2010)
Compliance with NICE guidelines in the management of self-harmThe Psychiatrist, 34
A. Mortimore, S. Cooper (2007)
The “4-hour target”: emergency nurses’ viewsEmergency Medicine Journal, 24
C. Fee, E. Weber (2007)
Identification of 90% of patients ultimately diagnosed with community-acquired pneumonia within four hours of emergency department arrival may not be feasible.Annals of emergency medicine, 49 5
Joint Commissioning Panel for Mental Health (JCP-MH) (2012) Guidance for Commissioners of Liaison Mental Health Services to Acute Hospitals
S. Steeg, Richard Emsley, M. Carr, J. Cooper, N. Kapur (2017)
Routine hospital management of self-harm and risk of further self-harm: propensity score analysis using record-based cohort dataPsychological Medicine, 48
S. Haq, D. Subramanyam, M. Agius (2010)
Assessment of self harm in an accident and emergency service - the development of a proforma to assess suicide intent and mental state in those presenting to the emergency department with self harm.Psychiatria Danubina, 22 Suppl 1
Debbie Lee (2003)
Reforming emergency care.British journal of perioperative nursing : the journal of the National Association of Theatre Nurses, 13 9
Alvaro Sanchez, P. Seriès, James Raymond, J. Steele (2017)
Modeling Trait Anxiety: From Computational Processes to PersonalityFrontiers in Psychiatry, 8
Myrna Weissman (1976)
PSYCHIATRIC DIAGNOSESActa Psychiatrica Scandinavica, 53
(2013)
Self-harm: Quality Standard. NICE Nuffield Trust (2019) A&E waiting times. QualityWatch. Nuffield Trust & The Health Foundation website
Michael Haslam (2019)
How the emergency department four-hour target affects clinical outcomes for patients diagnosed with a personality disorder.Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association, 27 4
(2019)
A&E attendances and emergency admissions
J. Gorski, R. Batt, E. Otles, M. Shah, A. Hamedani, B. Patterson (2016)
The Impact of Emergency Department Census on the Decision to AdmitAcademic Emergency Medicine, 24
Louise Hoyle, A. Grant (2015)
Treatment targets in emergency departments: nurses' views of how they affect clinical practice.Journal of clinical nursing, 24 15-16
Deborah Wise-Harris, D. Pauly, Deborah Kahan, Jason Bibiana, Stephen Hwang, V. Stergiopoulos (2017)
“Hospital was the Only Option”: Experiences of Frequent Emergency Department Users in Mental HealthAdministration and Policy in Mental Health and Mental Health Services Research, 44
M. Betz, E. Boudreaux (2016)
Managing Suicidal Patients in the Emergency Department.Annals of emergency medicine, 67 2
Lina Magnusson, G. Ahlström (2017)
Patients’ Satisfaction with Lower-limb Prosthetic and Orthotic Devices and Service delivery in Sierra Leone and MalawiBMC Health Services Research, 17
A. Downing, R. Wilson, M. Cooke (2004)
Which patients spend more than 4 hours in the Accident and Emergency department?Journal of public health, 26 2
Shari Welch (2010)
Twenty Years of Patient Satisfaction Research Applied to the Emergency Department: A Qualitative ReviewAmerican Journal of Medical Quality, 25
M. Dawood, Julia Gamston (2019)
An intervention to improve retention in emergency nursing.Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association
The purpose of this paper is to consider the influence of the Emergency Department (ED) target wait time upon the discharge decision in ED, specifically for patients who have self-harmed. Pressures to discharge patients to avoid breaching the 4-h target wait time, potentially increase the risk of adverse responses from clinicians. For the patient who has self-harmed, such interactions may be experienced as invalidating and may result in adverse outcomes.Design/methodology/approachSecondary data analysis was applied to the retrospective referral data of a Mental Health Liaison Team (MHLT), collected over a period of 11 months from a single hospital in the North of England. In total, 734 episodes of care were referred to the team from ED, where the primary presentation was recorded as self-harm.FindingsOver half of patients referred to the MHLT from ED having self-harmed were seen after already breaching the target and the potential for a more restrictive outcome reduced. Of those patients seen within 4 h, the potential for a more restrictive treatment option was increased.Practical implicationsRecommendations to improve the patient journey for those who have self-harmed include mental health triage and treatment in clinical areas outside of the target.Social implicationsThis study challenges the concept of the target as being realistic and attainable for patients who have self-harmed.Originality/valueThis exploratory study provides a starting point from which to explore the impact of the target time upon discharge decisions and clinical outcomes specifically for those who have self-harmed.
Journal of Public Mental Health – Emerald Publishing
Published: Jun 2, 2020
Keywords: Self-harm; Emergency Department; Target; Clinical outcomes; Mental health liaison; Wait times
Read and print from thousands of top scholarly journals.
Already have an account? Log in
Bookmark this article. You can see your Bookmarks on your DeepDyve Library.
To save an article, log in first, or sign up for a DeepDyve account if you don’t already have one.
Copy and paste the desired citation format or use the link below to download a file formatted for EndNote
Access the full text.
Sign up today, get DeepDyve free for 14 days.
All DeepDyve websites use cookies to improve your online experience. They were placed on your computer when you launched this website. You can change your cookie settings through your browser.