A new publication from the National Institute for Health and Care Excellence (NICE) designed to help commissioners ensure that the needs of people who self-harm are being addressed in the services they commonly use has been welcomed by mental health charity YoungMinds.
NICE’s publication focuses on three key service components: improving knowledge and awareness of self-harm; treatment and onward referral; and family and carer support. It is illustrated with service examples and shows how commissioners can improve the quality of care for people who self-harm, in line with the NICE quality standard.
The advice highlights that for people who have self-harmed, staff attitudes are often reported as contributing factors to poor experiences of care. It recommends that commissioners ask providers to improve the assessment and treatment of people who self-harm as a priority.
In addition, the resource provides advice for commissioners on collecting local data on self-harm in order to build up a comprehensive picture of the local activity because robust data on it is difficult to obtain or verify. This is because most self-harm is unseen by healthcare workers and, when an individual does attend a healthcare service, self-harm is not always recorded accurately.
The resource also contains a commissioning and budgeting tool that commissioners can use to demonstrate potential costs associated with increasing access to psychosocial assessments and psychosocial interventions.
Support for commissioning
While the support for commissioning draws on existing NICE recommendations and the NICE quality standard for self-harm, it does not constitute formal NICE guidance and is intended as a tool to help the NHS improve patient care through effective commissioning.
Professor Gillian Leng, deputy chief executive and director of Health and Social Care at NICE said: “Self-harm is very common, with estimates suggesting that around 180,000 people aged 15 years and older attend hospital after self-harming each year. Although most people who self-harm do not wish to end their lives, it does increase the likelihood that the person will eventually die by suicide by between 50- and 100-fold. Making commissioning decisions based on the NICE self-harm quality standard and guidance will contribute to improvements in health and social care outcomes by ensuring that staff coming into contact with people who self-harm in any setting are provided with appropriate training to help them better understand the problem of self-harm, and provide the right assessment, treatment and follow up.”
Lucie Russell, director of campaigns and policy at YoungMinds, said the charity welcomed the publication as a step towards improving support for the 1 in 12 children and young people who will self-harm at some stage in their lives.
“We revealed last year in ‘Talking Self-harm’ some of the major gaps in support for those in frontline healthcare positions and we will be playing our part in holding commissioners to account in implementing the recommendations.
“As well as healthcare professionals we also know from parents, teachers and young people that they feel like there is a lack of support for them and ways should be explored to increase their knowledge about how to support children and young people who self-harm.
“We are particularly pleased to see an emphasis on involving those who self-harm in planning and delivering the training to staff. Feedback from professionals who attend our own self-harm training, delivered with children and young people, reveals an enhanced perspective and more confidence in how to respond.”