Deliberate self-harm: the St Andrew’s experience

Deliberate self-harm: the St Andrew’s experience Deliberate Self-Harm (DSH) resulting in multiple cuts to the forearms and wrists is an increasingly common problem in the UK, providing a regular source of referrals for hand trauma services in the UK. It requires the input of both the mental health services and appropriate surgical services and frequently long-distance transfers to regional hand trauma centres. In providing for a minimum standard of care, as stipulated by the UK Department of Health in 1984 (Department of Health and Social Security 1984 ), for this often behaviourally challenging subset of patients, recommendations were made that all DSH patients have a mental health assessment prior to discharge. The care of such patients is frequently labour intensive in its demands on nursing staff demanding skills and expertise that may be better provided for by psychiatric staff (Royal College of Psychiatrists 1994 ), but little advice is available for the specific context in which plastic surgeons should manage this subset of patients. Retrospective data was gathered between 1996 and 2005 to ascertain the demographic profile of patients, previous self-harm and mental health history, and the patterns of injury and; to assess by long-term follow-up residual disabilities incurred by the injuries. In total, there were 228 individual patients presenting on 270 occasions with a male to female ratio of 3:2. The average duration as an inpatient was for 2–3 days. Being a large regional hand trauma unit, the catchment area within which such referrals are made, makes coordinating the safe discharge and appropriate follow-up of these patients particularly difficult. Despite the benefits of a large mental health unit on site, local versus regional funding issues have historically made patient care difficult. Multi-specialty cooperation and appropriate funding has significantly improved the level of patient supervision and quality of discharge for these patients in the last 10 years, but this has occurred with varying levels of success at a predominantly local level. European Journal of Plastic Surgery Springer Journals

Deliberate self-harm: the St Andrew’s experience

Loading next page...
Copyright © 2010 by Springer-Verlag
Medicine & Public Health; Plastic Surgery
Publisher site
See Article on Publisher Site


You’re reading a free preview. Subscribe to read the entire article.

DeepDyve is your
personal research library

It’s your single place to instantly
discover and read the research
that matters to you.

Enjoy affordable access to
over 12 million articles from more than
10,000 peer-reviewed journals.

All for just $49/month

Explore the DeepDyve Library

Unlimited reading

Read as many articles as you need. Full articles with original layout, charts and figures. Read online, from anywhere.

Stay up to date

Keep up with your field with Personalized Recommendations and Follow Journals to get automatic updates.

Organize your research

It’s easy to organize your research with our built-in tools.

Your journals are on DeepDyve

Read from thousands of the leading scholarly journals from SpringerNature, Elsevier, Wiley-Blackwell, Oxford University Press and more.

All the latest content is available, no embargo periods.

See the journals in your area

Monthly Plan

  • Read unlimited articles
  • Personalized recommendations
  • No expiration
  • Print 20 pages per month
  • 20% off on PDF purchases
  • Organize your research
  • Get updates on your journals and topic searches


Start Free Trial

14-day Free Trial

Best Deal — 39% off

Annual Plan

  • All the features of the Professional Plan, but for 39% off!
  • Billed annually
  • No expiration
  • For the normal price of 10 articles elsewhere, you get one full year of unlimited access to articles.



billed annually
Start Free Trial

14-day Free Trial