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Integrated care pathway for self-harm: our way forward
  1. Mukesh Kripalani1,
  2. Sath Nag2,
  3. Sagarika Nag3,
  4. Amanda Gash3
  1. 1The Northern Deanery, Newcastle Upon Tyne, UK
  2. 2James Cook University Hospital, Middlesbrough, UK
  3. 3Roseberry Park Hospital, Middlesbrough, UK
  1. Correspondence to Dr Mukesh Kripalani, Roseberry Park Hospital, Middlesbrough TS4 3AF, UK; drmukesh{at}


Background Balancing pressures of the 4-h wait in Accident and Emergency (A&E) and the National Institute for Clinical Excellence (NICE) requirement for a psychosocial assessment (PSA) before leaving hospital for patients presenting with self-harm is a challenge. This paper suggests a new method for coping with this demand.

Methods A score of 5 or above on the Modified Sad Persons Scale (MSPS), rated by general hospital staff, would result in an automatic admission to the general hospital for detailed PSA by the dedicated liaison psychiatry team the following day.

Results Most patients are usually admitted due to medical concerns. Only a small number of patients needed further psychiatric inpatient admission.

Conclusions This integrated care pathway (ICP) is evidence of true multidisciplinary working resulting in mutually beneficial outcomes for both the acute and mental health trusts.

  • Integrated care pathway
  • self-harm
  • liaison psychiatry
  • psychosocial assessment
  • modified SAD person's scale
  • management
  • emergency department management
  • management
  • risk management
  • mental health
  • self harm
  • poisoning
  • deliberate self
  • wounds
  • assessment

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  • Competing interests SatN and SagN were involved in the presentation for the Better Services for people who self-harm review. All authors have worked as a part of the ICP.

  • Provenance and peer review Not commissioned; externally peer reviewed.