PDF(Pubmed)
Abstract：
OBJECTIVE: The few studies that have explored self-harm presentation times at hospital emergency departments (EDs) - an important factor that can determine if a patient receives a mental health assessment - primarily focus on adult samples. This study examined the times of self-harm presentations to EDs, self-harm methods used, mental health assessments, and admission data across different age-groups.
METHODS: Using data from the National Self-Harm Registry Ireland over a 13-year timeframe (2007-2019), this study compared times, days, seasons, methods of self-harm, and admission data for children (8-12 years), adolescents (13-17 years), young adults (18-25 years) and adults (> 25 years).
RESULTS: The majority of the 152,474 self-harm presentations (78.6%) for all ages occurred out-of-hours (outside the standard working hours or in-hours times of 09:00-17:00, Monday-Friday). The four hours before midnight had the highest proportions of self-harm presentations for adolescents (27.9%) and adults (23.1%), whereas the four hours after midnight had the highest proportion of self-harm presentations for young adults (22.9%). The 16:00-midnight timeframe had highest proportion of self-harm presentations in children (52.3%). Higher proportions of patients received a mental health assessment in-hours compared to out-of-hours among young adults (78.2% vs. 73.3%) and adults (76.1% vs. 72.0%). Self-harm presentations were lowest during summer months in children and adolescents.
CONCLUSIONS: Hospitals should ensure that adequate resources are available for individuals presenting with self-harm, especially in the case of overcrowded EDs, and protocols need to be designed for those presenting with self-harm due to intoxication. In line with national policy, protocols for patients presenting during out-of-hours should be designed that can incorporate services from allied health multidisciplinary teams, social work, addiction services and counselling organisations. Given the lower rates of self-harm during school holidays for children and adolescents, the school environment must be considered in the context of mental health and self-harm public health prevention interventions.
METHODS: Using data from the National Self-Harm Registry Ireland over a 13-year timeframe (2007-2019), this study compared times, days, seasons, methods of self-harm, and admission data for children (8-12 years), adolescents (13-17 years), young adults (18-25 years) and adults (> 25 years).
RESULTS: The majority of the 152,474 self-harm presentations (78.6%) for all ages occurred out-of-hours (outside the standard working hours or in-hours times of 09:00-17:00, Monday-Friday). The four hours before midnight had the highest proportions of self-harm presentations for adolescents (27.9%) and adults (23.1%), whereas the four hours after midnight had the highest proportion of self-harm presentations for young adults (22.9%). The 16:00-midnight timeframe had highest proportion of self-harm presentations in children (52.3%). Higher proportions of patients received a mental health assessment in-hours compared to out-of-hours among young adults (78.2% vs. 73.3%) and adults (76.1% vs. 72.0%). Self-harm presentations were lowest during summer months in children and adolescents.
CONCLUSIONS: Hospitals should ensure that adequate resources are available for individuals presenting with self-harm, especially in the case of overcrowded EDs, and protocols need to be designed for those presenting with self-harm due to intoxication. In line with national policy, protocols for patients presenting during out-of-hours should be designed that can incorporate services from allied health multidisciplinary teams, social work, addiction services and counselling organisations. Given the lower rates of self-harm during school holidays for children and adolescents, the school environment must be considered in the context of mental health and self-harm public health prevention interventions.
摘要：
目的：少数研究探讨了医院急诊科（ED）的自我伤害表现时间-一个可以确定患者是否接受心理健康评估的重要因素-主要集中在成人样本上。这项研究检查了对ED的自我伤害陈述的时间，使用的自我伤害方法，心理健康评估,以及不同年龄段的入院数据。
方法：使用爱尔兰国家自我伤害登记处在13年时间框架（2007-2019年）内的数据，这项研究比较了时间，days,季节,自我伤害的方法，和儿童（8-12岁）的入院数据，青少年（13-17岁），年轻人（18-25岁）和成年人（>25岁）。
结果：所有年龄段的152,474份自我伤害报告（78.6％）中的大多数发生在工作时间外（在标准工作时间或周一至周五09:00-17:00的工作时间之外）。午夜前四个小时，青少年（27.9％）和成年人（23.1％）的自我伤害表现比例最高，而午夜后4小时的年轻人出现自我伤害的比例最高(22.9%).午夜16:00的时间框架在儿童中出现自我伤害的比例最高（52.3％）。与年轻人的非工作时间相比，在工作时间内接受心理健康评估的患者比例更高（78.2％vs.73.3%）和成年人（76.1%vs.72.0%）。儿童和青少年在夏季的自我伤害表现最低。
结论：医院应确保为出现自残的个人提供足够的资源，尤其是在过度拥挤的ED的情况下，和协议需要为那些表现出自我伤害由于中毒。符合国家政策,在非工作时间期间就诊的患者的协议应设计为可以纳入专职医疗多学科团队的服务，社会工作,成瘾服务和咨询组织。鉴于儿童和青少年在学校放假期间的自残率较低，必须在心理健康和自我伤害公共卫生预防干预措施的背景下考虑学校环境。
方法：使用爱尔兰国家自我伤害登记处在13年时间框架（2007-2019年）内的数据，这项研究比较了时间，days,季节,自我伤害的方法，和儿童（8-12岁）的入院数据，青少年（13-17岁），年轻人（18-25岁）和成年人（>25岁）。
结果：所有年龄段的152,474份自我伤害报告（78.6％）中的大多数发生在工作时间外（在标准工作时间或周一至周五09:00-17:00的工作时间之外）。午夜前四个小时，青少年（27.9％）和成年人（23.1％）的自我伤害表现比例最高，而午夜后4小时的年轻人出现自我伤害的比例最高(22.9%).午夜16:00的时间框架在儿童中出现自我伤害的比例最高（52.3％）。与年轻人的非工作时间相比，在工作时间内接受心理健康评估的患者比例更高（78.2％vs.73.3%）和成年人（76.1%vs.72.0%）。儿童和青少年在夏季的自我伤害表现最低。
结论：医院应确保为出现自残的个人提供足够的资源，尤其是在过度拥挤的ED的情况下，和协议需要为那些表现出自我伤害由于中毒。符合国家政策,在非工作时间期间就诊的患者的协议应设计为可以纳入专职医疗多学科团队的服务，社会工作,成瘾服务和咨询组织。鉴于儿童和青少年在学校放假期间的自残率较低，必须在心理健康和自我伤害公共卫生预防干预措施的背景下考虑学校环境。
