title: Back so soon: rapid re-presentations to the emergency department following intentional self-harm.
abstract: OBJECTIVE
  To describe the number, characteristics and management of patients who presented to an emergency department (ED) with intentional self-harm and then re-presented for any reason within 1 week, over a 1-year period.
  
  
  METHODS
  A retrospective records review from one New Zealand ED over 12 months.
  
  
  RESULTS
  Of the 120 patients who attended the ED more than once with intentional self-harm, 48 re-presented on 73 occasions within 7 days of the index presentation. Of the re-presentations, 55% occurred within 1 day. Mental health assessments by emergency department staff were minimal; challenging incidents occurred in 40% of presentations; and there was an increase in the inpatient admission rate for second presentations.
  
  
  CONCLUSIONS
  We identified a small group of patients who rapidly re-present to the ED following intentional self-harm. The reasons behind those re-presentations could include limited mental health assessments in ED and inadequate follow-up on discharge. System improvements in the ED including better collaboration with mental health services could improve how services address the needs of patients who present with intentional self-harm and reduce costs.
authors: Social Psychiatry and Population Mental Health Research Unit, University of Otago Wellington, PO Box 7343, Wellington South, Wellington 6024, New Zealand. silke.kuehl@otago.ac.nz
authors: Silke
authors: S
authors: Kuehl
authors: Katherine
authors: K
authors: Nelson
authors: Sunny
authors: S
authors: Collings
mesh_terms: D000293:Adolescent; D000328:Adult; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D016728:Self-Injurious Behavior; D013997:Time Factors