GPs should regularly review self-harm patients, says draft NICE guidance

GPs should regularly review self-harm patients and offer a specific CBT intervention, according to a consultation on the first new guidance for self-harm to be drawn up in 11 years.

The new draft guidance emphasises the importance of referring patients to specialist mental health services, but stresses that, for patients who are treated in primary care, continuity is crucial.

If someone who has self-harmed is being treated in primary care, GPs must ensure regular follow-up appointments and reviews of self-harm behaviour, as well as a medicines review, the draft guideline say.

They must also provide care for coexisting mental health issues, including referral to mental health services where appropriate, as well as information, social care, voluntary and non-NHS sector support and self-help resources.

The guidance says that referring people to mental health services would ‘ensure people are in the most appropriate setting’.

However, the committee agreed that ‘if people are being cared for in primary care following an episode of self-harm, there should be continuity of care and regular reviews of factors relating to their self-harm to ensure that the person who has self-harmed feels supported and engaged with services’.

The draft guidance, out for consultation until 1 March, also says ambulance staff should suggest self-harming patients see their GP to maximise the chance of engagement with services.

It says: ‘When attending a person who has self-harmed but who does not need urgent physical care, ambulance staff and paramedics should discuss with the person (and any relevant services) if it is possible for the person to be assessed or treated by an appropriate alternative service, such as a specialist mental health service or their GP.’

It notes that ‘ambulance staff often felt that the emergency department was not the preferred place that the person who had self-harmed wanted to be taken. They agreed that referral to alternative services could facilitate the person’s engagement with services’.

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Source: Pulse, 18 January 2022