title: From efficacy to effectiveness: managing organisational change to improve health services for young people with deliberate self harm behaviour.
abstract: Repeat Deliberate Self Harm is a recognised risk factor for completed suicide and therefore reduction by effective health service response represents a valid contribution to suicide prevention. However, only a small fraction of people with deliberate self harm presentations to general health settings actually reach specialist mental health follow-up appointments. Therefore, even if responses at that point are known to be effective they do not make a significant contribution to reducing repeat self-harm overall. We describe health system organisational change strategies to improve health service engagement for the target group, and present data demonstrating the effectiveness of these strategies.
authors.affiliation: School of Psychiatry, University of New South Wales.
authors.forename: M J
authors.initials: MJ
authors.lastname: Tobin
authors.forename: A R
authors.initials: AR
authors.lastname: Clarke
authors.forename: R
authors.initials: R
authors.lastname: Buss
authors.forename: S L
authors.initials: SL
authors.lastname: Einfeld
authors.forename: J
authors.initials: J
authors.lastname: Beard
authors.forename: M
authors.initials: M
authors.lastname: Dudley
authors.forename: M
authors.initials: M
authors.lastname: Knowles
authors.forename: U
authors.initials: U
authors.lastname: Dietrich
mesh_terms: D000293:Adolescent; D000296:Adolescent Psychiatry / Q000458:organization & administration* / Q000592:standards; D003266:Continuity of Patient Care / Q000458:organization & administration; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000458:organization & administration / Q000592:standards*; D009517:New South Wales; D009936:Organizational Innovation; D010865:Pilot Projects; D015397:Program Evaluation; D012307:Risk Factors; D016728:Self-Injurious Behavior / Q000150:complications / Q000628:therapy*; D013405:Suicide / Q000523:psychology; D017749:Total Quality Management / Q000458:organization & administration*; D000092864:Suicide Prevention