title: A cross sectional study of assessed need and multiple service use among a self harm population: informing the development of inter-agency integrated care.
abstract: OBJECTIVE
  To examine assessed need and wider health and social care service contact for a total Deliberate Self Harm (DSH) population in the UK.
  
  
  METHODS
  The study first recorded assessed needs and referrals for this population, then used a new method of identifying and describing all other agency contacts for this population by combining the total anonymised DSH population data with total mental health, health and social care agency populations for one geographical area.
  
  
  RESULTS
  For a DSH unit population of 427, half (53%) were assessed with mental health and 18% with drug or alcohol problems; two thirds were referred to appropriate services. Wider service contact for a total DSH population (n=2,205 over three years) confirmed that 53% had contacted mental health (compared to 2.9% of the geographical area population (n=646,239) and 7.4% of the total hospital Emergency population (n=91,911). The DSH population was three times more likely to contact social care agencies (21.1%: 7.2%) and ten times more likely to attend drug (7.3%: 0.7%) and alcohol agencies (8.8%: 0.8%)
  
  
  CONCLUSIONS
  This new method described the wider service use of one vulnerable shared care population, it is suggested that the method could be used to inform the development of integrated care initiatives in different areas.
authors.affiliation: Centre for Primary Care and Public Health, School of Health and Social Care, University of Reading, Bulmershe Court, Reading, RG6 1HY. j.keene@reading.ac.uk
authors.forename: J
authors.initials: J
authors.lastname: Keene