Emergency Healthcare Staff Training (EHS) in the Assessment and Management of Deliberate Self Harm (DSH): Implementation and Evaluation

The overall aim of this project is to improve the quality of care for all patients who present to hospital emergency departments following self harm using training and the systematic roll-out of an electronic self harm assessment and information system.

How is this project structured?

This project involves three levels. Each level has individual objectives.

Level 1 involves the development and delivery of a 2-hour self-harm and suicide awareness and skills-based training to all emergency healthcare staff (EHS) using the Train-The-Trainer (TTT) model. The objectives of this training are to: a) Increase knowledge and understanding of self-harm and suicide among emergency healthcare staff; b) Promote a positive attitude regarding self-harm and suicide prevention among emergency healthcare staff and c) Increase emergency healthcare staff confidence in the management of self-harm or suicidal patients. It is envisaged that improved knowledge, attitudes and confidence in the management of self-harm patients presenting to ED’s will improve patient experiences of acute care, patient outcomes and ultimately reduce the risk of repeated self-harm or eventual suicide.

Level 2 involves the development and delivery of a one-day training programme to mental healthcare staff in the management and assessment of self-harm and suicidal behaviour using the TTT model. The objectives of this training are to enhance the assessment procedure and crisis management of self-harm patients within the acute care setting.

Level 3 involves the development and roll-out of a structured electronic self-harm assessment and information system. The objectives of this system are to facilitate data collection and the assessment and follow-up of self-harm patients as well as the early identification of those with a pattern of repeat self-harm presentations.

How many staff have received this training?

To date, the 2-hour training this has been rolled out to 102 emergency healthcare staff.

Has this project been evaluated?

Yes and key findings of the evaluation of the 2-hour training in relation to mental health services are outlined below:

  • The majority of participants had received no training in relation to mental health prior to the training.
  • Similar to the self-harm awareness training programme a substantial proportion of participants (72%) had received no previous training in relation to depression, with a further 91% having not received any training in relation to self-harm.
  • A further 92% of participants had not received any training in relation to suicide or suicide prevention and 70% had no training in crisis response.
  • Similarly to self-harm training post-training improvements were reported in all areas targeted by the training.
  • Post-training significant positive changes were found in relation to participants attitudes towards deliberate self-harm and in confidence in participants management of at risk patients. Positive improvements were also found in participant’s attitudes towards suicide prevention and their knowledge and understanding of self-harm.

I would like more information about this project!

This and other information on this project can be found in our 2015 Report.

 Who was involved in this project?

Project Coordinator: Ms. Caroline Daly

Principal Investigators: Professor Ella Arensman (NSRF) and Dr. Eugene Cassidy (Cork University Hospital)