The research, conducted by the NIHR GM PSRC, National Confidential Inquiry into Suicide and Safety in Mental Health Services (NCISH) and the Manchester Self-Harm Project (MaSH), shows that people who have self-harmed non-fatally are many times more likely to subsequently die by suicide than other people of the same age and gender. Self-harm services are often experienced as fragmented, with inequalities in accessing care. Only half of patients presenting to hospital following self-harm receive a psychosocial assessment, though evidence shows assessments could decrease repeat self-harm presentations by 40%.

The team worked closely with Integrated Care Systems nationally to improve community-based support for self-harm, and with liaison psychiatry teams to increase the provision of psychosocial assessments. Through their national collaborative programme with NHSE – Commissioning for Quality and Innovation (CQUIN) –  all 42 Integrated Care Systems in England developed an evidence-based community self-harm service offer, which resulted in a national 10% overall increase in psychosocial assessments (according to national evidence from NHS England). This translates to a real-world improvement of approximately 10,000 emergency department presentations following self-harm, with those patients now receiving high-quality, evidence-based care.

The researchers are continuing to work on improving healthcare services for self-harm and suicide prevention. Over the next two years, members from NCISH and the NIHR GM PSRC will be leading the moving away from risk assessment component in the national Culture of Care Programme.