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Global prevalence of psychosocial assessment following hospital-treated self-harm: systematic review and meta-analysis

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Title: Global prevalence of psychosocial assessment following hospital-treated self-harm: systematic review and meta-analysis
Authors: Katrina Witt, Katie McGill, Bernard Leckning, Nicole T. M. Hill, Benjamin M. Davies, Jo Robinson, Gregory Carter
Source: BJPsych Open, Vol 10 (2024)
Publisher Information: Cambridge University Press, 2024.
Publication Year: 2024
Collection: LCC:Psychiatry
Subject Terms: Self-harm, suicide, mental health services, psychosocial interventions, risk assessment, Psychiatry, RC435-571
More Details: Background Hospital-treated self-harm is common, costly and associated with repeated self-harm and suicide. Providing a comprehensive psychosocial assessment following self-harm is recommended by professional bodies and may improve outcomes. Aims To review the provision of psychosocial assessments after hospital-presenting self-harm and the extent to which macro-level factors indicative of service provision explain variability in these estimates. Method We searched five electronic databases to 3 January 2023 for studies reporting data on the proportion of patients and/or events that were provided a psychosocial assessment. Pooled weighted prevalence estimates were calculated with the random-effects model. Random-effects meta-regression was used to investigate between-study variability. Results 119 publications (69 unique samples) were included. Across ages, two-thirds of patients had a psychosocial assessment (0.67, 95% CI 0.58–0.76). The proportion was higher for young people and older adults (0.75, 95% CI 0.36–0.99 and 0.83, 95% CI 0.48–1.00, respectively) compared with adults (0.64, 95% CI 0.54–0.73). For events, around half of all presentations had these assessments across the age range. No macro-level factor explained between-study heterogeneity. Conclusions There is room for improvement in the universal provision of psychosocial assessments for self-harm. This represents a missed opportunity to review and tailor aftercare supports for those at risk. Given the marked unexplained heterogeneity between studies, the person- and system-level factors that influence provision of psychosocial assessments after self-harm should be studied further.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 2056-4724
Relation: https://www.cambridge.org/core/product/identifier/S2056472423006257/type/journal_article; https://doaj.org/toc/2056-4724
DOI: 10.1192/bjo.2023.625
Access URL: https://doaj.org/article/32129cd1a65c4323b13443ce98b3b193
Accession Number: edsdoj.32129cd1a65c4323b13443ce98b3b193
Database: Directory of Open Access Journals
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  Data: Background Hospital-treated self-harm is common, costly and associated with repeated self-harm and suicide. Providing a comprehensive psychosocial assessment following self-harm is recommended by professional bodies and may improve outcomes. Aims To review the provision of psychosocial assessments after hospital-presenting self-harm and the extent to which macro-level factors indicative of service provision explain variability in these estimates. Method We searched five electronic databases to 3 January 2023 for studies reporting data on the proportion of patients and/or events that were provided a psychosocial assessment. Pooled weighted prevalence estimates were calculated with the random-effects model. Random-effects meta-regression was used to investigate between-study variability. Results 119 publications (69 unique samples) were included. Across ages, two-thirds of patients had a psychosocial assessment (0.67, 95% CI 0.58–0.76). The proportion was higher for young people and older adults (0.75, 95% CI 0.36–0.99 and 0.83, 95% CI 0.48–1.00, respectively) compared with adults (0.64, 95% CI 0.54–0.73). For events, around half of all presentations had these assessments across the age range. No macro-level factor explained between-study heterogeneity. Conclusions There is room for improvement in the universal provision of psychosocial assessments for self-harm. This represents a missed opportunity to review and tailor aftercare supports for those at risk. Given the marked unexplained heterogeneity between studies, the person- and system-level factors that influence provision of psychosocial assessments after self-harm should be studied further.
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