Training to improve emergency care following self-harm

22/02/2016 by Amy Gaskin-Williams

A recent story on Patient Opinion raised concerns about emergency care at Queens Medical Centre following an episode of self-harm. Excerpts from the story are posted below (please click here to read the full story on Patient Opinion):

I suffer from Complex Post Traumatic Stress Disorder and subsequently have mental health problems…. When I am in this state I disassociate and today I found myself in the bathroom with scissors in my hand and had stabbed myself in the chest. I knew I needed medical attention and stitches so I reluctantly went to A&E …The doctor recognised me. He briefly looked at my wound… He bought a kit over and coldly stitched my wound and then said he would get DPM (Department of Psychological Medicine) to see me… At 4.30 he left me curled under my coat, cold and upset and never spoke to me again …I was wheeled into the other side of A&E and placed in the middle of the department on a trolley.

…At 9am I finally saw a man from DPM. He told me to go home and to call my MHT tomorrow. I told him how frightened I was about hurting myself and that I was in pain. I asked for one tablet for tonight so I had something to calm me down but he told me I had to ring 111 and he couldn't help me.…I left the department at 9.30, really upset.

…No one cared that I was upset, cold, in pain and alone and I got the impression that they think if they treat me like that I won't do it again but unfortunately mental health doesn't work like that and I don't have a lot of control. I am waiting for in patient trauma therapy and am happy to engage in any way it can in order to get better. The New Year is the anniversary of a major traumatic event and is a hard time for me. I have had very little sleep, too many flashbacks and nightmares and feel very suicidal and low. Last night’s care has just made me feel worse and the worrying thing is that I'm not sure I will ever go back but what do I do when I need urgent care … I have never complained before and am so appreciative of the support I receive. This time, however I want an explanation as to why I was treated so badly and in such an uncaring manner.”

A response was published by Jo Horsley, Adult Mental Health Service Manager, apologising and requesting that the patient contact her directly. She also offered to meet the patient if that was their preference.

A meeting was arranged, at which the patient shared their full experience. It was established that the doctor referred to in the posting was an emergency department doctor, and Jo has planned to meet with emergency department managers to discuss this case. As part of the Vanguard project looking at urgent care services, the Trust is shortly to provide mental health awareness training for emergency department staff – this patient has been invited to co-deliver this training as she is a qualified teacher and has delivered training previously.

In relation to the other issues with the DPM (Department of Psychological Medicine) member of staff, the patient was satisfied that this had been addressed informally within management structures.