Improving Care in Self-Harm HIT review of 2014-15

Salena Williams, Director of the Improving Care in Self-Harm Health Integration Team (STITCH HIT) gives an update on the HIT’s activities in 2014-15.

Suicide prevention is a national priority and self-harm is
the strongest risk factor for suicide: half of all people who take their own
lives have previously self-harmed. The Improving Care in Self-Harm (STITCH) HIT
is working to reduce the number of suicides and self-harm episodes in the
Bristol area by improving treatment and care for people who self-harm,
transforming understanding across the health service and ensuring treatment is
evidence based.

Bristol commissioners have funded extended hours and the
expansion of the Psychiatric Liaison Team at University Hospitals Bristol NHS
Foundation Trust. The team now operate seven days a week from 8am to
10pm. One of the aims of this investment is that more patients who have
self-harmed receive psychiatric assessment.

We also strive to improve patient satisfaction and health
outcomes. Our activities are underpinned by the Bristol-wide Self-harm
Surveillance Register, which provides crucial information for self-harm care in
Emergency Departments in Bristol, as well as ensuring all service changes are
evaluated in real-time. This approach is being adopted elsewhere in the West,
including in Bath, Swindon and Salisbury.

STITCH has called for
an overhaul of prescribing rules, which triggered an investigation by the
British Medical Association
’s General Practitioner Committee
into the dispensing of medicines lethal in
overdose. We are also improving treatment and care for people who self-harm
by using research to identify gaps in service provision. The Self Injury, Self
Help involvement group have developed a leaflet on self-harm for Emergency
Departments.

We aim to improve staff knowledge, attitudes and management
of people who self-harm or who are at risk of suicide. Service users and mental
health staff are working on self-harm care training for Emergency Department
staff, and we are continuing our training for GPs.

Over the last year more than 100 self-harm patients have
contributed to three research projects, with research papers published in major
journals. We have also successfully bid for National Institute for Health
Research Collaboration for Leadership in Applied Health Research and Care West
(NIHR CLAHRC West) research into patient reported outcome measures.