title: Deliberate self-harm and substance dependence: the management of patients seen in the general hospital.
abstract: The aim of this study was to examine management decisions made at the time of assessment of an episode of deliberate self-harm seen in the general hospital and examine the extent of referral to a specialized addiction unit. Factors involved in making a clinical decision regarding the appropriate management of self-harm cases when alcohol factors were identified are reviewed. Simply referring to a specialized addiction unit was found to be an unsatisfactory method of providing a comprehensive response to the problem of substance misuse and deliberate self-harm. It is suggested that services should be developed using active posthospital discharge community follow-up. Motivational interviewing used in such a setting may increase the number of patients who will go on to accept specialist care.
authors.affiliation: Community Mental Health Care Directorate, Whiteley Wood Clinic, Sheffield, Great Britain.
authors.forename: K
authors.initials: K
authors.lastname: Wylie
authors.forename: A
authors.initials: A
authors.lastname: House
authors.forename: D
authors.initials: D
authors.lastname: Storer
authors.forename: D
authors.initials: D
authors.lastname: Raistrick
authors.forename: M
authors.initials: M
authors.lastname: Henderson
mesh_terms: D000328:Adult; D003657:Decision Making; D005260:Female; D006769:Hospitals, General / Q000458:organization & administration*; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012307:Risk Factors; D016728:Self-Injurious Behavior / Q000628:therapy*; D019966:Substance-Related Disorders / Q000628:therapy*; D013405:Suicide; D006113:United Kingdom