Table 2

Differences in the process of care before and after the extended LPS

January–March 2014
(n=373)
January–March 2015
(n=381)
Difference (abs)p Value
Psychosocial assessment n (%)*213 (57)258 (68)+45 (+11%)0.003
Assessor for those who had a, n (%)*(n=213)(n=258)
 Psychiatrist109 (51)77 (30)−32 (−21%)<0.001
 Liaison nurse71 (33)166 (64)+95 (+31%)
 Other24 (5.9)13 (5.0)−1 (−0.9%)
 Unknown9 (5.9)2 (0.8)−10 (−5.1%)
Psychosocial assessment by hour of day, n (%)*
Monday to Friday 09:00–17:00 hours133 (62)117 (46)−16 (−16%)<0.001
All other times61 (29)121 (47)+60 (+18%)
Unknown19 (8.9)20 (7.8)+1 (-1.1%)
Median time from ED arrival to psychosocial assessment†11 hours 44 min8 hours 30 min−3 hour 14 min<0.017
Median time from medical assessment to psychological assessment†
 Overall9 hours 30 min (n=185)6 hours 53 min (n=230)−2 hour 37 min<0.001
 Attendances between 09:00 and 17:00 hours2 hours 51 min (n=44)2 hours 59 min (n=60)+8 min0.078
 Attendances during other hours10 hours 20 min (n=141)8 hours 28 min (n=170)−1 hour 52 min0.003
Admission to ward, n (%)*
   No121 (32)117 (31)−4 (−1%)0.110
   Yes—observation ward212 (58)238 (63)+26 (+5%)
   Yes—ITU9 (2.5)2 (0.5)−7 (−2%)
   Yes—other24 (6.6)21 (5.6)−3 (−1%)
Median (p25–75) duration of hospital stay if not admitted (hours)No data‡12 (7–21)
Mean duration of hospital stay if admitted (days)§1.7 (4.1)1.4 (2.8)−0.370.26§
Median (p25–75) duration of hospital stay if admitted to ward/ITU (days)¶1 (1–1)1 (1–1)=0.004
Total admission days (including ITU)480393−87
Outcome of ED attendance, n (%)*
 Psychiatric inpatient admission11 (2.9)11 (2.9)-/-0.96
 Crisis team46 (12)58 (15)+12 (+3%)0.25
 Other community team27 (7.2)58 (15)+31 (+8%)0.001
 Self-harm clinic57 (15)18 (4.7)−39 (−10%)<0.001
 Alcohol nurse service19 (5.1)20 (5.2)+1 (+0.1%)0.92
 Home/GP care only94 (25)89 (23)−5 (−2%)0.56
 Social services0 (0)3 (0.8)+3 (+0.8%)0.086
 Voluntary agency0 (0)13 (3.4)+13 (+3.4%)<0.001
 Custody25 (6.7)14 (3.7)−11 (−3%)0.061
 Died0 (0)1 (0.3)+1 (+0.3%)0.51
Patients self-discharging before a psychosocial assessment is carried out, n (%)*73 (20)51(13)−22 (−7%)0.022
Episodes with repeat self-harm<90 days, n (%)
 Total repeat episodes (min–max)**105 (0–19)97 (0–9)−8 (−8%)0.79
 First repeat after index, n (%)48 (18)54 (17)+6 (-1%)
  First episode of self-harm, n (%)3 (5.6)2 (4.3)−1 (−1.3%)
  Previous self-harm, n (%)45 (21)52 (20)+7 (−1%)
  • *p Value based on Χ2 test.

  • †p Value based on log-rank test.

  • ‡This element was not documented from the start of the self-harm register.

  • §p Value based on bootstrap corrected t-test statistic.

  • ¶p Value based on Wilcoxon-Mann-Witney test.

  • **p Value based on Wilcoxon-Mann-Witney test for # attendances per patient.

  • ††p Value based on Cox regression, adjusted for previous self-harm, sex and suicide risk.

  • ED, emergency department; ITU, intensive treatment unit; LPS, liaison psychiatric service.