Do patients who self-harm consult their general practitioner soon after hospital discharge? A cohort study.
BACKGROUND
Deliberate self-harm (DSH, attempted suicide) is one of the most common reasons for emergency hospital admission in Great Britain. Approximately 20 % of patients repeat self-harm in the 12 months after admission. The GP's role in DSH aftercare and the prevention of repeat episodes is unclear.


METHODS
The data were obtained from a 12-month follow-up of a series of 968 consecutive patients from 49 practices who attended an accident and emergency (A&E) department in Bristol or Bath, UK, following an episode of self-harm between 26(th) May 1997 and 1(st) March 1999.


RESULTS
Information on consultation patterns were available for 681 (70 %) of the patients. Two hundred and fourteen (31 %) of these consulted their GP in the week following the episode, 360 (53 %) within 4 weeks. Of the subjects, 44 % were discharged directly from A & E; these patients were more likely to consult their GP in the 4 weeks after the episode. Over the 12-month follow-up, 117 (17 %) attended hospital for a repeat episode of DSH; 9 % of these repeats occurred within 1 week and 28 % within 4 weeks of the index event. Although few (2 out of 11 patients--18 %) of those repeating in the first week after the index episode consulted their GP prior to repeating, 50 % (11/22) of those who repeated in the 1-4 weeks after an episode did so.


CONCLUSIONS
Consultation patterns indicate that most people who deliberately self-harm consult their GP soon after the episode. This consultation may provide an opportunity for preventing repeat DSH and suicide.
Gunnell
D
D
Department of Social Medicine, Canynge Hall, Whiteladies Road, Bristol, UK. D.J.Gunnell@bristol.ac.uk
Bennewith
O
O
Peters
T J
TJ
Stocks
N
N
Sharp
D J
DJ
D000293:Adolescent; D000328:Adult; D000359:Aftercare / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D004739:England; D005194:Family Practice / Q000706:statistics & numerical data*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000534:rehabilitation; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D012008:Recurrence; D013406:Suicide, Attempted / Q000517:prevention & control*; D013997:Time Factors