People who decline psychiatric assessment are more likely to repeat self harm

To see whether the way incidents of self harm are managed affects the risk of repetition of self harm Crawford and Wessely investigated 294 patients in south London who attended an accident and emergency department (p 985). Over 18 months 54 repeated self harm: they were more likely to have had a history of self harm and of substance misuse than those who did not repeat self harm. Patients who discharged themselves from the accident and emergency department before an initial psychiatric assessment had three times the rate of repetition of self harm as those who completed the assessment.