2019-20 Improving Care in Self-Harm (STITCH) HIT successes

Improving Care in Self-Harm Health Integration Team (STITCH HIT) Directors Drs Becky Mars, Lucy Biddle and Sandra Walker reflect on the team’s achievements in 2019-20.

The HIT welcomed two new directors, Dr Becky Mars (University of Bristol) and Dr Sandy Walker (North Bristol NHS Trust), who join existing director Lucy Biddle. Nik Munien stood down as Co-Director of the STITCH HIT this year.

Training on self-harm and suicide awareness has been delivered to more than 70 GPs including ‘top-tips’ for supporting individuals who are feeling suicidal. Evaluation of the programme has been positive with clinicians reporting it has improved their knowledge and confidence.

We completed a piece of work around personal support plans, which are now embedded in practice. The model has been shared nationally as a safe and effective means of improving care and reducing Emergency Department attendance.

Another key workstream developed this year focuses on student’s mental health and wellbeing. STITCH members have provided direct teaching on self-harm and related issues to healthcare students at the University of West of England and we plan to extend this to undergraduate medical students at the University of Bristol. STITCH Director Lucy Biddle is also leading a project around online help resources for young people/students.

While data collection for the Bristol Self Harm Surveillance Register has continued, we have had to reduce the amount of data we collect due to lack of funding. Findings from the register on suicide and self-harm related internet use have been published and have helped to inform online safety policies. Findings have also been published looking at domestic violence and self-harm. The self-harm register is a valuable resource, however securing long-term funding remains a challenge.

New funding has been received from University Hospitals Bristol and Weston NHS Foundation Trust (UHBW) and Bristol hospitals charity Above and Beyond to explore suicide prevention for Emergency Department attenders presenting with self-harm and a history of substance misuse, using data from the self-harm register (led by Professor Paul Moran).

We have received funding from Bristol Health Partners and from Above and Beyond to start an exciting new project led by STITCH Director Sandy Walker. The project will explore ways of closing the gap between primary care and NHS mental health services.

We started presenting to the Bristol schools’ mental health lead forums in 2018 and this work has continued in 2019.

Two patient satisfaction surveys were carried out this year: one by Bristol Independent Mental Health Network (BIMHN) service user group and one by NHS England.

We also became part of national research around psychological outpatient interventions for self-harm patients last year and the Self-Harm Outpatient (SHOP) Clinic continues to be permanently funded UHBW-funded outpatient clinic.