Evidence & Practice
Developing, implementing and evaluating a model for an outpatient self-harm service
Fiona Brand Research nurse, Centre for Suicide Research, University Department of Psychiatry, University of Oxford, Oxford, England
To reduce the incidence of self-harming behaviour in individuals who presented regularly to the emergency department in one hospital following self-harm, as well as to improve their well-being and experience of care.
This was a 12-month nurse-led practice development project to develop, implement and evaluate a brief-intervention outpatient service for individuals who presented to the emergency department following self-harm and who were identified as being at risk of further self-harm. The service improvement was informed by an action research process and the principles of appreciative inquiry.
The project provided a short-term outpatient follow-up service, known as Brief Interventions in Repeat Self Harm (BIRSH), to patients who presented to the emergency department following self-harm, and who were considered at risk of further self-harm. The intervention enabled the clinician to validate the patient's distress and offer them short-term outpatient follow-up care. The BIRSH sessions were offered to 38 patients. A total of 26 patients attended one or more BIRSH session, and all of these individuals showed a reduction in the number of presentations to the emergency department following self-harm in the six months following the intervention, compared to the six months before the intervention.
The BIRSH outpatient service appears to have been a contributory factor in reducing self-harm for patients who engaged with the service. The service improvement was informed by an action research process and the principles of appreciative inquiry, which provided a positive, focused approach to the practice development project.
Nursing Standard. doi: 10.7748/ns.2017.e10229Correspondence
Received: 20 July 2015
Accepted: 26 January 2016
Published online: 08 May 2017