Short summary

Self-harming behavior can lead to fatal consequences as a result of the injuries inflicted.

This study is

1) An observational study. 20 patients admitted to the ED as a result for selfharm or suicide attempt will be followed,

2) Focusgroup interviews with nurses and physicians from the ED and psychiatry will be conducted. They will be asked to discus the results from study 1 to develop initiatives to improve the processes for self-harming patients in the ED.

Rationale

In Denmark there are annual 7,800 somatic hospitalizations and 4,300 emergency contacts as a result of self-harming or suicidal behavior. The injuries can be inflicted as an affect regulation as well as a coping strategy to relieve difficult thoughts, feelings or inner psychological pain.

Therefore it is a complex group of patients there arrives to the emergency departments after suicidal attempts and/or self-harming behavior. This complexity is further challenged by the physical conditions in emergency departments, waiting time for treatment, but also scarce personnel resources. The staff in the emergency department can feel powerless and frustrated. This is often triggered by the combination of self-harming patients with repeated contacts, and the nurses' experience of a lack of competence.

The present project therefore seeks to: 1) gain knowledge about patients admitted to the emergency department (ED) as a result of self-harming behavior. How is the treatment, care, cultures, relationships, challenges and resources as well as collaboration and cross-cutting workflows; 2) To develop initiatives to improve the processes for self-harming patients in the ED based on the results and the knowledge generated in study 1.

Description of the cohort

We will inclued 20 patients admitted to the ED as a result of self harm or a suicide attempt.

Data and biological material

We will follow 20 patients attmitted to the ED. We aspire to follow the patients for 3-5 hours in the ED and then again in the hours around the discharge or transfer to a psychiatric department. We wil also follow the patients by their medical records while they are hospitalized and up to 6 months after the observation period.

Collaborating researchers and departments

Forskningsenheden for psykiatri, børn og voksne Åbenrå, Institut for regional Sundhedsforskning, SDU

• Elsebeth Stenager MD, PhD, Proefessor.