Patrick J Sullivan
Journal of Medical Ethics
Published Online First: 09 February 2017.
doi: 10.1136/medethics-2015-103146
Abstract
This paper considers the ethical justification for the use of harm minimisation approaches with individuals who self-injure. While the general issues concerning harm minimisation have been widely debated, there has been only limited consideration of the ethical issues raised by allowing people to continue injuring themselves as part of an agreed therapeutic programme. I will argue that harm minimisation should be supported on the basis that it results in an overall reduction in harm when compared with more traditional ways of dealing with self-injurious behaviour. It will be argued that this is an example of a situation where healthcare professionals sometimes have a moral obligation to allow harm to come to their patients.
The article is here.
Showing posts with label Self-Abuse. Show all posts
Showing posts with label Self-Abuse. Show all posts
Wednesday, March 1, 2017
Saturday, June 2, 2012
Outpatient Care of Young People After Emergency Treatment of Deliberate Self-Harm
By Dennis Thompson
MedicineNet.com
Originally published on May 25, 2012
Doctors have long known that some kids suffering severe emotional turmoil find relief in physical pain -- cutting or burning or sticking themselves with pins to achieve a form of release.
But researchers now are questioning whether enough is being done to reach out to these young people and help them before they do themselves irreparable damage.
One study this year found that six of every 10 adolescents who went to an emergency room for treatment after harming themselves were released without receiving a mental health assessment or any follow-up mental health care. The findings were reported in the February issue of the Journal of the American Academy of Child & Adolescent Psychiatry.
Here is a link to the summary of this article.
The original research is below.
by Jeffrey Bridge, Steven Marcus, and Mark Olfson
Journal of the American Academy of Child & Adolescent Psychiatry
Volume 51, Issue 2 , Pages 213-222.e1, February 2012
MedicineNet.com
Originally published on May 25, 2012
Doctors have long known that some kids suffering severe emotional turmoil find relief in physical pain -- cutting or burning or sticking themselves with pins to achieve a form of release.But researchers now are questioning whether enough is being done to reach out to these young people and help them before they do themselves irreparable damage.
One study this year found that six of every 10 adolescents who went to an emergency room for treatment after harming themselves were released without receiving a mental health assessment or any follow-up mental health care. The findings were reported in the February issue of the Journal of the American Academy of Child & Adolescent Psychiatry.
Here is a link to the summary of this article.
The original research is below.
by Jeffrey Bridge, Steven Marcus, and Mark Olfson
Journal of the American Academy of Child & Adolescent Psychiatry
Volume 51, Issue 2 , Pages 213-222.e1, February 2012
Objective
Little is known about the mental health care received by young people after an episode of deliberate self-harm. This study examined predictors of emergency department (ED) discharge, mental health assessments in the ED, and follow-up outpatient mental health care for Medicaid-covered youth with deliberate self-harm.Method
A retrospective longitudinal cohort analysis was conducted of national 2006 Medicaid claims data supplemented with the Area Resource File and a Substance Abuse and Mental Health Services Administration Medicaid policy survey of state policy characteristics focusing on ED treatment episodes by youth 10 to 19 years old for deliberate self-harm (n = 3,241). Rates and adjusted risk ratios (ARR) of discharge to the community, mental health assessments in the ED, and outpatient visits during the 30 days after the ED visit were assessed.Results
Most patients (72.9%) were discharged to the community. Discharge was inversely related to recent psychiatric hospitalization (ARR 0.75, 99% confidence interval [CI] 0.63–0.90). Thirty-nine percent of discharged patients received a mental health assessment in the ED and a roughly similar percentage (43.0%) received follow-up outpatient mental health care. Follow-up mental health care was directly related to recent outpatient (ARR 2.58, 99% CI 2.27–2.94) and inpatient (ARR 1.33, 99% CI 1.14–1.56) mental health care and inversely related to Hispanic ethnicity (ARR 0.78, 99% CI 0.64–0.95) and residence in a county with medium-to-high poverty rates (ARR 0.84, 99% CI 0.73–0.97).Conclusions
A substantial proportion of young Medicaid beneficiaries who present to EDs with deliberate self-harm are discharged to the community and do not receive emergency mental health assessments or follow-up outpatient mental health care.
Friday, February 17, 2012
Most Teens Who Self-Harm Are Not Evaluated for Mental Health in ER
By Mary Elizabeth Dallas
MedicineNet.com
Most children and teens who deliberately injure themselves are discharged from emergency rooms without an evaluation of their mental health, a new study shows.
The findings are worrisome since risk for suicide is greatest right after an episode of deliberate self-harm, according to researchers at Nationwide Children's Hospital in Columbus, Ohio.
The researchers also found the majority of these kids do not receive any follow-up care with a mental health professional up to one month after their ER visit.
"Emergency department personnel can play a unique role in suicide prevention by assessing the mental health of patients after deliberate self-harm and providing potentially lifesaving referrals for outpatient mental health care," said lead study author Jeff Bridge, principal investigator at the hospital's Center for Innovation in Pediatric Practice, in a news release. "However, the coordination between emergency services for patients who deliberately harm themselves and linkage with outpatient mental health treatment is often inadequate."
The story can be found here.
The study is from Child & Adolescent Psychiatry, Volume 51, Issue 2, pages 213-222. Here is the conclusion of the study from the abstract.
MedicineNet.com
The findings are worrisome since risk for suicide is greatest right after an episode of deliberate self-harm, according to researchers at Nationwide Children's Hospital in Columbus, Ohio.
The researchers also found the majority of these kids do not receive any follow-up care with a mental health professional up to one month after their ER visit.
"Emergency department personnel can play a unique role in suicide prevention by assessing the mental health of patients after deliberate self-harm and providing potentially lifesaving referrals for outpatient mental health care," said lead study author Jeff Bridge, principal investigator at the hospital's Center for Innovation in Pediatric Practice, in a news release. "However, the coordination between emergency services for patients who deliberately harm themselves and linkage with outpatient mental health treatment is often inadequate."
The story can be found here.
The study is from Child & Adolescent Psychiatry, Volume 51, Issue 2, pages 213-222. Here is the conclusion of the study from the abstract.
"A substantial proportion of young Medicaid beneficiaries who present to EDs with deliberate self-harm are discharged to the community and do not receive emergency mental health assessments or follow-up outpatient mental health care."
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