Self-poisoning: management of patients in Nottingham, 1976.

Analysis of the management of a sample of patients with drug overdoses in Nottingham in 1976 showed that some 10% of the patients who arrived in the casualty department after an overdose were neither admitted nor seen by a psychiatrist. Of the patients who were admitted to medical wards for psychiatric evaluation, 31% were thought to need no further psychiatric action while the default-rate in those who were referred to a psychiatric outpatient clinic was 43%. Both these endpoints showed considerable variations among the 10 psychiatric teams, but of every 100 patients with drug overdose who arrived in the casualty department, 51 left hospital without continuing psychiatric or social action having been taken. As the recommendations of the Hill Committee are not being implemented we suggest that they should be critically re-examined and that the indication for, and value of, psychiatric intervention should be determined.