Thursday 19 July 2018

Hundreds of suicide-risk patients quit A&E unseen

Last year, there were 6,928 presentations of patients who had self-harmed or were expressing suicidal thoughts. Stock image
Last year, there were 6,928 presentations of patients who had self-harmed or were expressing suicidal thoughts. Stock image
Eilish O'Regan

Eilish O'Regan

Hundreds of patients who attend hospital A&Es seeking help for thoughts of suicide or self-harm are leaving before being assessed, a new report has revealed.

As many as 689 of these highly distressed patients checked out before consulting a medical team over the course of a year.

The rate of these patients abandoning A&Es ranges from 5.2pc in some hospitals to as high as 27pc in others.

A total of 16 patients died in A&Es as a result of self-inflicted injuries during the period under examination.

It highlights how many of these patients are continuing to fall through the cracks in busy A&Es as hospitals grapple with the trolley crisis.

Last year, there were 6,928 presentations of patients who had self-harmed or were expressing suicidal thoughts. In some cases, the same patients returned a number of times.

The report's author, Dr Ann Jeffers, a psychiatrist and the HSE's clinical lead for driving improvements in its care, said there were some examples of excellent practice and there would be further developments next year.

Dr Jeffers, who is a working psychiatrist in Galway, was appointed last February to spend two days a week overseeing the step-by-step care that these patients should get.

Her report shows that just 12 of the country's 29 A&Es have a dedicated suitable room for the assessment of patients with mental-health needs.

"We are looking to get these rooms in place in all emergency departments," she said.

Alcohol was involved in the cases of 668 of these anguished patients.

Of the 6,239 presentations where the patient received a biopsychosocial assessment - involving questions about their psychological and physical health - 32pc were seen by a senior nurse, 42pc by a junior doctor and 22pc by a liaison nurse.

The recommendation is that the assessment should involve a senior nurse, a psychiatrist or a trainee doctor in psychiatry.

The patient's next of kin should be involved in the assessment and management of the patient, but this happened in only 61pc of cases, the annual report of the HSE's National Clinical Programme for this issue reveals.

Communication with GPs is paramount, but in only 61pc of presentations was a letter sent to the patient's GP within 24 hours of discharge.

Each patient should also get a follow-up phone call within a day of discharge from the A&E. However, a call was received in only 47pc of cases.

A total of 191 of the patients were aged under 15.

It was the third attempt at self-harm in a year for 794 of the patients.

The report said that while there were several examples of very good practice, there needed to be a range of improvements, including funding, to ensure that a senior nurse is available from 8am to 8pm seven days a week to provide proper assessment and follow-up.

Readers affected by this article can contact the Samaritans' 24-hour helpline: 116 123.

Irish Independent

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