The assessment and management of self-harming patients in an accident and emergency department: an action research project.

The Government, in Health of the Nation (DoH, 1992), set targets for health authorities to introduce specific interventions intended to reduce the rates of suicide in the districts for which they are responsible. Those who deliberately harm themselves are an important group for interventions aimed at suicide prevention. Self-harming individuals are known to seek help from a range of care providers, not just those specifically intended to meet their needs. Individuals with problems of self-poisoning and self-injury have placed increasing pressure on general hospital staff involved in their care. There should therefore be adequate services for suicide attempters in every general hospital. Policies and protocols must be introduced and evaluated, to ensure that the self-harmer's experience during crisis is not a catalogue of unhelpful encounters. This paper is an account of an action research project concerned with the assessment and management of self-harming patients in one accident and emergency department. The project aimed to enhance departmental policies and procedures for managing this group of patients. Practical problems can inhibit the introduction of even the most desirable of innovations. Action research provides a way of overcoming these problems whilst doing research at the same time.