title: Evidence-based practice for young people who self harm: can it be sustained and does it improve outcomes?
abstract: In 1998-1999, two Area Health Services in NSW conducted a project to implement evidence-based service enhancements for the clinical management of young people who present with Deliberate Self Harm (DSH) behaviour. The present study examined what structures and procedures were required to implement and sustain evidence-based practice in different health care settings for patients with DSH behaviour. Service provision was assessed at three points during the initial project to assess the degree of change that occurred, and 9 months after the completion of the project to allow an assessment of sustainability of the service provision. We examined staff perceptions of the importance of education, management directives, policy and procedure changes, and cultural/attitudinal changes, in implementing clinical best practice. Results indicated that support from both service management and clinical staff is necessary for successful implementation of service enhancements. High levels of staff education and policy development were also associated with high levels of service performance. The best sustained enhancements were those that were developed by the services themselves.
authors.affiliation: Child & Adolescent Psychiatry Programs, South East Health, Kogarah.
authors.forename: Stewart L
authors.initials: SL
authors.lastname: Einfeld
authors.forename: John
authors.initials: J
authors.lastname: Beard
authors.forename: Margaret
authors.initials: M
authors.lastname: Tobin
authors.forename: Richard
authors.initials: R
authors.lastname: Buss
authors.forename: Michael
authors.initials: M
authors.lastname: Dudley
authors.forename: Adam R
authors.initials: AR
authors.lastname: Clarke
authors.forename: Michelle
authors.initials: M
authors.lastname: Knowles
authors.forename: Blake
authors.initials: B
authors.lastname: Hamilton
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D019985:Benchmarking; D002391:Catchment Area, Health; D004637:Emergency Services, Psychiatric / Q000458:organization & administration / Q000592:standards; D019317:Evidence-Based Medicine / Q000458:organization & administration*; D005260:Female; D018453:Homeless Youth / Q000523:psychology; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000458:organization & administration* / Q000592:standards; D009517:New South Wales; D010865:Pilot Projects; D015397:Program Evaluation; D016728:Self-Injurious Behavior / Q000517:prevention & control*; D019966:Substance-Related Disorders; D019037:Urban Health Services / Q000458:organization & administration* / Q000592:standards; D035862:Vulnerable Populations