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Clinical management of self-harming children and adolescents in the United Kingdom: a multicentre audit

Published online by Cambridge University Press:  26 August 2025

R. S. Goh ,
H. McAdam ,
F. Allman ,
G. Cheung ,
J. Alsop ,
S. Pandey ,
A. Hook ,
B. Perry ,
D. Codling  and
J. Randall
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R. S. Goh*
Affiliation:
Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London
H. McAdam
Affiliation:
University of Glasgow NHS Greater Glasgow and Clyde (Scotland Foundation School), Glasgow
F. Allman
Affiliation:
Newcastle University NCIC NHS FT, Newcastle
G. Cheung
Affiliation:
Hull York Medical School York and Scarborough Teaching Hospitals NHS Foundation Trust, York
J. Alsop
Affiliation:
University of Warwick, Warwickshire
S. Pandey
Affiliation:
Luton and Dunstable NHS Foundation Trust, Luton
A. Hook
Affiliation:
Great Western Hospitals NHS Foundation Trust, Swindon
B. Perry
Affiliation:
University of Cambridge, Cambridge
D. Codling
Affiliation:
South London and Maudsley NHS Foundation Trust, London
J. Randall
Affiliation:
Great Western Hospitals NHS Foundation Trust, Swindon
J. R. Harrison
Affiliation:
Translational and Clinical Research Institute, Faculty of Medical Science, Newcastle University, Campus for Ageing and Vitality, Newcastle
K. Beck
Affiliation:
King’s College London, London, United Kingdom
*
*Corresponding author.

Abstract

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Introduction

The risk of self-harm is highest in younger age groups, with increasing numbers of under-18s being admitted to hospital due to self-harm in recent years in the UK1,2. The National Institute for Health and Care Excellence (NICE) guidelines for self-harm in adolescents over eight was updated in September 2022 and reinforces the need for the proper initial management of adolescent self-harm3. To our knowledge, our study is the first UK national audit on the management of self-harm in adolescents presenting to the emergency department using the updated NICE guidelines.

Objectives

To assess the clinical management of children and adolescents who present to the Emergency Department (ED) following self-harm, a cross-sectional, multicentre study was conducted within teaching hospitals affiliated with nine medical schools across England, Wales and Scotland.

Methods

Data was retrospectively collected from ED records using consecutive sampling of individuals aged 8 to 17 years who presented with self-harm from 7 Sep-7 Nov 2022.

Results

Records from 328 patients were included in the final analysis. Most patients were female (82.0%) and white (68.2%), with a mean age of presentation of 14.7 (σ = 1.58). The rate of positive responses to each question is available in Table 1. A ‘positive’ response is defined as a ‘yes’ response, rather than ‘no’ or ‘not documented’.

Table 1.

Rate of compliance with audit criteria

StudyInterventionSample SizeOutcome MeasureKey Findings
Lamy et al. (2020)SGAs (multiple RCTs)>50 trialsABC, CGISignificant reduction in irritability (p<0.05)
Ghanizadeh et al. (2014)Aripiprazole, Risperidone59ABCReduction in symptoms; fewer adverse events with aripiprazole
King et al. (2009)Citalopram, Placebo149CGI, CY-BOCSNo significant benefit over placebo; more adverse effects

Conclusions

This is the first study, to our knowledge, that investigates the management of self-harm in under 18s across the UK using the updated NICE guidelines. Some criteria may have been adhered to but not documented. The results from this study provide support for the further improvement of clinical practice in the management of self-harming children and adolescents.

Disclosure of Interest

None Declared

Information

Type
Abstract
Information
European Psychiatry , Volume 68 , Special Issue S1: Abstracts of the 33rd European Congress of Psychiatry , April 2025 , pp. S760
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of European Psychiatric Association
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