| Child psychiatrist Sally Bonnar, based at the Centre for Child Health in Dundee, said today that on average around 150 children a year across Tayside were referred for specialist help because they were self-harming.
The youngest child she had treated for deliberate self-harm was eight, although the numbers requiring help at such a young age were few.
“These are very rare,” said Dr Bonnar. “The vast majority are 13 to 16-year-olds and more girls than boys.”
Deliberate self-harming takes a variety of forms including hanging, burning, pulling out hair, but most commonly occurs as cutting or overdosing.
Locally, child and adolescent mental health services (CAMHS) have undergone major changes over the last couple of years, redesigning the service and taking on extra staff because waiting times for children seeking help were “unacceptable” with the longest waits previously around two years.
Around 40 children a week, some not even old enough to attend school, are referred to CAMHS with a variety of mental health problems and staff prioritise these cases at a weekly team meeting.
Even now children can wait up to six months for help because demand for services outstrips capacity, though self-harmers now “jump the queue”.
While psychologists have been recruited to the CAMHS, boosting the service available to children with general mental health problems, there has also been a turn around in the service to self-harmers with the appointments of two highly-trained specialist nurses able to respond rapidly.
The nurses are available seven days a week, with a consultant or senior specialist doctor on-call during the night.
Dr Bonnar said the arrangement allowed self-harmers to “jump the queue” and be seen and assessed within hours of a referral.
Prior to the introduction of the nurses to work specifically with young people who deliberately self-harm, the service was delivered by doctors engaged in a variety of other duties, who could be anywhere in Tayside and “caught up” in other problems when they were informed of a self-harm emergency.
Dr Bonnar said in the past a self-harming child admitted to A&E at Ninewells or Perth Royal Infirmary in the morning, could wait until late in the day, and after five o’clock at night, until medical staff (from CAMHS) got to see the child referred as an emergency.
“Clearly that was not ideal,” said Dr Bonnar. “All the other support services have clocked off and gone home.”
To better respond to the needs of children who deliberately self-harm, the specialist nurse service was established.
“Our deliberate self- harm nurses can go out to A&E within two hours,” said Dr Bonnar. “Young people can be seen that day and an assessment made of their mental health needs and the nurses can either follow them up themselves or, if a young person with serious mental health problems needs a more complicated piece of work, they will get seen within the department or can be referred on appropriately, to a social worker or one of the voluntary sector agencies.”
Dr Bonnar said no clinician liked to have waiting lists for treatment but gave a reassurance that real emergencies would get a rapid response whether they were children deliberately self harming or with other mental health problems.
“If a GP phones in with a real emergency, the child gets seen that day,” said Dr Bonnar. “If it’s an urgent case, it will be seen within a week. If it’s a routine case it will take on average six months.” |
