Deeble Issues Brief No. 47: Hospital-treated self-harm: Improving care through improved data

Self-harm is a public health priority. It usually occurs in the context of psychological distress and is frequently directly associated with suicidal intent, psychosocial stressors and for many, mental ill-health. Hospital-treated self-harm accounts for over 30,000 hospital admissions each year and is the strongest independent risk factor for later suicide. 

Routine care for hospital-treated self-harm is variable and can be substandard. Many people report that they experienced stigmatising, judgemental and invalidating responses when presenting to health services for help after self-harm or when in suicidal crisis. Furthermore, care is not meeting many patients’ needs and linkage to mental health services after discharge is not routine. Despite this, there is no data infrastructure to support hospitals to address these issues. Instead, monitoring and service improvement relies on one-off or localised investigations. 

This Issues Brief recommends establishing a clinical quality registry for hospital-treated self-harm as a recognised mechanism for linking data to improved care. The paper also highlights the need to build collaborative capacity within the sector to allow existing units with emerging self-harm clinical registry capability transform into a network of sentinel units. This will enhance existing self-harm surveillance and be a concrete step in building sector capability for a hospital-treated self-harm clinical quality registry.