Identifying the elements of effective hospital management of self-harm
Research type
Research Study
Full title
Identifying the elements of effective hospital management of self-harm.
IRAS ID
145408
Contact name
Robert Carroll
Contact email
Sponsor organisation
University of Bristol
Research summary
A quarter of all patients who die by suicide are seen in hospital following self-harm in the year before their death. Hospital presenting self-harm thus represents a key opportunity for suicide prevention. Despite this, there is considerable uncertainty about how best to assess, manage and treat self-harm patients to reduce their risk of repetition. Using Hospital Episode Statistics data, this investigation aims to clarify important components in the clinical care of self-harm.
There is a lack of evidence to guide basic questions regarding the effective clinical care of self-harm patients. One of the most basic of these questions includes whether or not to admit patients who self-harm to a medical bed, regardless of the medical severity of their act. Only one RCT has investigated whether admission to a medical bed reduces self-harm patients risk of subsequent self-harm. However this study was too small to accurately describe the treatment effect. Some observational studies have been undertaken however they often suffer from confounding.
The aim of the current project will be to investigate the effect of medical admission and other aspects of care on self-harm patients' risk of repeat self-harm and suicide. To overcome the limitations of previous research in the area, a novel application of instrumental variable analysis will be used.
The dataset being requested will include Accident and Emergency Hospital Episode Statistics (HES) data, Inpatient HES data, and Office for National Statistics mortality data. The linkage of these data sets will allow us to assess which self-harm patients are admitted to a hospital bed, and evaluate their outcomes, specifically in terms of repeat self-harm and subsequent death by suicide.
The analysis will result in a publication in a peer reviewed journal and help inform clinical practice.
REC name
North East - Newcastle & North Tyneside 2 Research Ethics Committee
REC reference
14/NE/0039
Date of REC Opinion
5 Feb 2014
REC opinion
Favourable Opinion