Authors: Pitman, Alexandra¹; Tyrer, Peter²

Source: Psychology and Psychotherapy: Theory, Research and Practice, Volume 81, Number 4, December 2008 , pp. 377-397(21)

Abstract:

The NICE clinical guideline on self-harm has been criticized for its reliance on expert consensus view in the absence of evidence on psychological aspects of care. The relative dearth of published experiences in implementing these guidelines is a likely consequence of these doubts. This article highlights the methodological problems inherent to the development of guidelines covering the first 48 hours after a presentation of self-harm, and reviews four areas where implementation has advanced: change in staff attitudes; triage scales; psychosocial assessments; and specific interventions for borderline personality disorder (BPD). Suggestions are made for how future versions of the guidelines might be adapted to improve the process of referral for appropriate psychological care and to provide more equitable access to care for patients in distress.

Document Type: Research article

DOI: 10.1348/147608308X306897

Affiliations: 1: Department of Mental Health Sciences, Royal Free and University College Medical School, London, UK 2: Division of Neurosciences and Mental Health, Imperial College, Claybrook Centre, London, UK

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