More emotional support needed for self-harm patients at local A&E, says report

Self harmers 'at risk' at Stoke Mandeville hospital, says report
Self harmers 'at risk' at Stoke Mandeville hospital, says report

Healthwatch Bucks has found that the treatment at Stoke Mandeville A&E for people who have self-harmed is not in line with The National Institute for Health and Care Excellence(NICE) guidelines.

Healthwatch Bucks created an interview designed to check whether people’s experiences of treatments for self-harm were in line with the NICE (National Institute for Health and Care Excellence) guidelines. They enlisted the help of Buckinghamshire Mind who interviewed eight people.

Sarah was one of the people who Buckinghamshire Mind interviewed for this report.

She wanted to share her story and experience with us. She said that she had been to Wycombe Hospital many times for self-harm injuries.

She said the staff were always “really nice and non-judgemental”.

“They never said anything negative and were understanding,” she added.

However, she did say that at Stoke-Mandeville, she was spoken to in a waiting room instead of a private area for her PIRLS psychological assessment.

PIRLS is the mental-health team that assess people who have self-harmed to work out what needs to happen next.

The person said: “I felt so embarrassed I just had to get out of there without a discharge and I took a taxi home immediately.”

Dr Sian Roberts. Mental Health and Learning Disability Clinical Director for NHS Buckinghamshire Clinical Commissioning Group said: “We welcome the findings of this Healthwatch report and would like to thank all those patients who contributed to it.

"Our health services in Buckinghamshire work very hard to ensure patients who experience self harm injuries are treated with dignity and sensitivity, and we understand that the circumstances they are in may leave them feeling particularly vulnerable or exposed.

“We are currently working to address the points raised in the report to ensure that patient's experience of our services is as positive as possible. Included within this work is training of clinicians and staff as well as identifying private spaces for patients who may need them.

"In addition, we will support patients who self-harm to have a better understanding of how psychological treatment can benefit them.”

Many of the other people interviewed said the treatment of their injuries was good, and all said they received enough pain relief. Some people said the staff were “lovely” and “really nice”. But others felt they were being judged, and not everyone saw the value of their psychological assessment.

But others felt they were being judged. One person even said she was called “attention-seeking” by a member of staff.

Healthwatch Bucks have recommended that people who are having their PIRLS psychological assessment

Buckinghamshire Healthcare NHS Trust, Oxford Health NHS Foundation Trust (PIRLs) and the Buckinghamshire Urgent Care Alliance (Urgent Treatment Centre) make sure that private areas are available to discuss sensitive matters. These need to be clearly signposted.

Other recommendations to the Buckinghamshire Healthcare NHS Trust were:

->make sure that their clinical staff are given guidance in providing caring treatment and warned of the risk of appearing judgmental.

->ensure that all people who have self-harmed are identified and are consistently offered a safe and supportive place to wait, and the choice of someone to wait with them.

->review their current processes for ensuring that patients give consent to treatment and are informed about confidentiality. The process should ensure that this does happen and that patients are aware it has happened.

-> look at whether these recommendations apply to anyone who is in mental distress and implement them accordingly.

A statement from Buckinghamshire Mind said: "For support with self-harm, we recommend accessing the resources about self-harm on national Mind’s website.

"Buckinghamshire Mind offers help and support for local people experiencing a wide range of mental health problems.

"Our services include Befriending, Counselling for Adults and Young People, Education and Peer Support in Schools, Employment Support, Outreach, Training, Wellbeing and Peer Support groups and our Older Adults’ Service.

"Buckinghamshire Mind also provides an online directory of services, apps and other help available to anyone who is worried about their own mental health and well-being or that of a friend or relative."

Dr Sian Roberts. Mental Health and Learning Disability Clinical Director for NHS Buckinghamshire Clinical Commissioning Group, said: We would like to thank Healthwatch for compiling this report, and all the patients who contributed to it. Our health services in Buckinghamshire work very hard to ensure patients who experience self-harm injuries are treated with dignity and sensitivity, and we understand that the circumstances they are in may leave them feeling particularly vulnerable or exposed.

“We are currently working to address the points raised in the report to ensure that patient's experience of our services is as positive as possible. Included within this work is training of clinicians and staff as well as identifying private spaces for patients who may need them. In addition we will support patients who self-harm to have a better understanding of how psychological treatment can benefit them.”

Carolyn Morrice, Chief Nurse at Buckinghamshire Healthcare NHS Trust added: “The Healthwatch report has been extremely useful in helping the Trust strengthen the care and support we provide for patients who have self-harmed. As a result we have been able to put measures in place to improve our risk assessment of patients on an individual basis, these include the provision of a quiet private room within A&E and identifying patients who have self-harmed as part of our triaging system. We are committed to providing a safe and caring service for this vulnerable group of people and will continue to seek their views on how we can improve. ”