Original article

Characteristics of children and adolescents presenting to accident and emergency departments with deliberate self harm

Amulya Nadkarni¹, Andrew Parkin², Nisha Dogra², David D Stretch², Philip Adrian Evans³

¹ Thorneywood Child and Adolescent Mental Health Service, Nottingham
² Leicester University Division of Child Psychiatry, Greenwood Institute of Child Health, Westcotes House, Westcotes Drive, Leicester LE3 0QU
³ Leicester Royal Infirmary, Accident and Emergency Department, Leicester

Correspondence to:
Correspondence to: Dr Parkin, Senior Lecturer and Honorary Consultant

Objectives—The aim of this study was to provide a description of the characteristics of children and adolescents presenting to the accident and emergency (A&E) department with deliberate self harm.

Method—Descriptive analysis of data collected by reviewing the notes of all children and adolescents aged 16 years and under, presenting during the period of study (1 January to 31 December) with a history of deliberate self harm.

Results—A total of 100 children (18 boys, 82 girls) were responsible for 117 episodes of deliberate self harm. Nine repeaters were responsible for 22% of the attendances; 38% had made use of emergency ambulance service and 6% were referred by their general practitioner (GP). Sixty nine per cent were accompanied by immediate family and 21% children presented alone. Seventy four per cent presented within three hours of the attempt and 37% presented between 6 pm and midnight; 77% presented during weekdays and 30% of attempts had occurred during spring. Ninety two per cent had used a pharmaceutical drug. Sixty five per cent had made the attempt at home and 12% in a public place. Twenty five per cent had prior or current contact with the child psychiatric services and a similar proportion had prior or current contact with social services.

Conclusions—Few of the children and adolescents presenting with deliberate self harm to the A&E department have been referred by their GP. They frequently present alone or are accompanied by people who are not family members making assessment and treatment difficult. Many already have other services involved in their care and thus the gathering and dissemination of information can become quite lengthy. The time of presentation is usually out of hours, further complicating this process. A small number of young people present with repeated self harm, who are known to be most vulnerable for completing suicide.

Keywords: child and adolescent; deliberate self harm; parasuicide

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