A. Nadkarni et al., Characteristics of children and adolescents presenting to accident and emergency departments with deliberate self harm, J AC EMER M, 17(2), 2000, pp. 98-102
Objectives-The aim of this study was to provide a description of the charac
teristics of children and adolescents presenting to the accident and emerge
ncy (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 pe
riod 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 11
7 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 attemp
ts had occurred during spring. Ninety two per cent had used a pharmaceutica
l drug. Sixty five per cent had made the attempt at home and 12% in a publi
c place. Twenty five per cent had prior or current contact with the child p
sychiatric services and a similar proportion had prior or current contact w
ith 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 freque
ntly 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 informa
tion can become quite lengthy. The time of presentation is usually out of h
ours, further complicating this process. A small number of young people pre
sent with repeated self harm, who are known to be most vulnerable for compl
eting suicide.