Alcohol Related Deliberate Self Harm: What do Trends Recorded in a Liaison Psychiatry Service Tell Us?

Introduction Deliberate Self Harm (DSH) is the intentional self injury or self poisioning irrespective of type of motivation or degree of suicidal intent reflecting the often mixed nature of intentions associated with self... [ view full abstract ]

Introduction
Deliberate Self Harm (DSH) is the intentional self injury or self poisioning irrespective of type of motivation or degree of suicidal intent reflecting the often mixed nature of intentions associated with self harm. Studies have found that patients with hazardous use of alcohol are clearly more at risk of DSH because of its depressive effects, its impairment of problem solving and its aggravation of impulsive behaviour. Fifty percent of all suicides have been in contact with a mental health specialist. Fewer than 5% had been in contact with an addiction service before their death.

Aim & Method
A retrospective audit of the alcohol related DSH presentations to an ED, referred to a Liaison Psychiatry Service over a three year period (2010-2012 inclusive) and compared those trends with the national findings as documented.

Key Points
Overdose of medication was found to be the most common method of DSH in line with national findings.
Alcohol consumption amongst self harming females was significantly higher than the national figure whilst male figures were similar.
A significantly larger association was found between alcohol use and DSH than was found nationally.

Recommendations
Harm reduction and brief interventions in ED could increase awareness of the risks involved in the hazardous use of alcohol and might be expected to reduce incidents of intentional DSH, consequent medical care and thus costs, and perhaps also the number of completed suicides.
Specialist DSH Nurse to co-ordinate follow up for patients who have returned home after ED care and who have not required an inpatient admission, as well as those who left the ED without a care recommendation.