Self-harm: assessment, management and preventing recurrence (NICE, 7 September 2022)

Summary

This guideline from the National Institute for Health and Care Excellence (NICE) covers assessment, management and preventing recurrence for children, young people and adults who have self-harmed. It includes those with a mental health problem, neurodevelopmental disorder or learning disability and applies to all sectors that work with people who have self-harmed.

Content

The final guideline mirrors the draft guidance in advising that self-harming patients, when treated in primary care, must receive:

• regular follow-up appointments
• regular reviews of self-harm behaviour
• a regular medicines review.

The guidance also said:

• After an episode of self-harm, the format and frequency of initial aftercare and which services will be involved must be discussed with the patient. 
• If the psychosocial assessment after a self-harm episode was made by a GP, initial aftercare must be provided by the GP within 48 hours of the assessment.
• GPs should use consultations and medicines reviews as ‘an opportunity to assess self-harm if appropriate, for example, asking about thoughts of self-harm or suicide, actual self-harm, and access to substances that might be taken in overdose (including prescribed, over-the-counter medicines, herbal remedies and recreational drugs)’.

Reiterating existing guidance, the guideline added: ‘Do not offer drug treatment as a specific intervention to reduce self-harm.’