ArticleBJPsych open2020
Factors explaining variation in recommended care pathways following hospital-presenting self-harm: a multilevel national registry study.
Article in BJPsych open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 20 citations in OpenAlex.
- Accessing Care and Treatment in the Emergency Department for Self-Harm and Suicidal Ideation: A Qualitative Study of Service Users' Experiences.International journal of mental health nursing · 2026Article
- Association between utilisation of pre-hospital emergency services and premature discharge in Emergency Department attendances with mental health triage codes: a retrospective cohort study.BMC emergency medicine · 2026Article
- Cost of acute hospital treatment and initial aftercare for hospital-presenting self-harm in Ireland: national registry study.BJPsych open · 2026Article
- Understanding variation in the clinical management of self-harm and suicidal ideation in hospital emergency departments: qualitative implementation study.BJPsych bulletin · 2025Article
- Factors affecting implementation of a National Clinical Programme for self-harm in hospital emergency departments: a qualitative study.BMJ quality & safety · 2025Article
- A Multicenter Registry Experience for Suicidal Behaviors in Iran (2019-2022).Archives of Iranian medicine · 2024Article
- Suicide risk following ED presentation with self-harm varies by hospital.Social psychiatry and psychiatric epidemiology · 2024Article
- Global prevalence of psychosocial assessment following hospital-treated self-harm: systematic review and meta-analysis.BJPsych open · 2024Review
- Evaluation of a national clinical programme for the management of self-harm in hospital emergency departments: impact on patient outcomes and the provision of care.BMC psychiatry · 2023Article
- Global prevalence of psychiatric in- and out-patient treatment following hospital-presenting self-harm: a systematic review and meta-analysis.EClinicalMedicine · 2023Article
- Indigeneity and Likelihood of Discharge to Psychiatric Hospital in an Australian Deliberate Self-Poisoning Hospital-Treated Cohort.International journal of environmental research and public health · 2022Article
- Article
- A Comparison of Presentations with Self-Harm to Hospital in Lithuania and Ireland.International journal of environmental research and public health · 2021Article
Corrections and comments
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Authors and funding
3 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPeople who present to hospital following self-harm are at high risk of suicide. Despite this, there are considerable variations in the management of this group across hospitals and the factors influencing such variations are not well understood.
aimsThe aim of this study was to identify the specific hospital and individual factors associated with care pathways following hospital-presenting self-harm.
methodData on presentations to hospitals by those aged 18 years and over were obtained from the National Self-Harm Registry Ireland for 2017 and 2018. Factors associated with four common outcomes following self-harm (self-discharge, medical and psychiatric admission and psychosocial assessment before discharge) were examined using multilevel Poisson regression models.
resultsCare pathways following self-harm varied across hospitals and were influenced by both hospital and individual factors. Individual factors were primarily associated with self-discharge (including male gender, younger age and alcohol involvement), medical admission (older age, drug overdose as a sole method and ambulance presentations) and psychiatric admission (male gender, methods associated with greater lethality and older age). The hospital admission rate for self-harm was the only factor associated with all outcomes examined. The availability of psychiatric in-patient facilities and specialist mental health staff contributed to variation in psychiatric admissions and psychosocial assessments prior to discharge. Hospital factors explained the majority of observed variation in the provision of psychosocial assessments.
conclusionsCharacteristics of the presenting hospital and hospital admission rates influence the recommended care pathways following self-harm. Provision of onsite mental health facilities and specialist mental health staff has a strong impact on psychiatric care of these patients.
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