Accessing Help for Self-Harm & Suicidal Behaviour in the Emergency Department: a three-phase study

Accessing Help for Self-Harm & Suicidal Behaviour in the Emergency Dept: a three-phase research study

Phase I Qualitative Research Study by Trinity College for 3TS Reveals Need for Back to Basics Approach to Patient Care

Lack of understanding, labelling and the need for a ‘back to basics’ approach were some of the key findings to emerge from Phase I of our qualitative study into Accessing Help for Self-Harm and Suicidal Behaviour in the Emergency Department. 

Phase I focused on the experience of the service user attending the Emergency Department with self-harm, suicidal behaviours or an attempted suicide with the final report published in July 2020. Phase II of the study focussed on companions i.e. the family, friends or carers who accompany them. Phase III, commenced during 2026, studies the experience of staff at the Emergency Department.  

3TS commissioned these studies as part of our ongoing commitment to Suicide Prevention and Self Harm research. Research was carried out by researchers from the Mental Health Nursing Team at the School of Nursing and Midwifery, Trinity College Dublin, led by Dr Louise Doyle, Associate Professor of Mental Health Nursing.

Phase I - A Qualitative Study

Phase 1 focused on the personal experiences of 50 participants who had presented to the Emergency Department (ED) of Hospitals for self harm or suicidal behaviour throughout Ireland within the preceding 5 years. Just under half of participants reported presenting with suicidal ideation without self-injury. The remainder presented following self-harm which comprised overdose and / or self-cutting.

Variability in experiences, positive & negative 

An important primary point to note from this study is the significant variability in the experiences of participants. Some had more than one presentation to different EDs, yet reported positive experiences in one ED and negative experiences in another. Participants who presented more than once to the same ED also reported variability. Some had largely positive experiences and others negative.

“I’d just say, the best advice I could possibly give is actually listen to the person that’s sitting in front of you. They’re not just a number, they’re not just there for the sake of being there. They’re asking for help, we’re crying out for help….” (ED15)

This important research represents the very personal experiences of many people who attend our EDs at a time of crisis seeking both emergency physical and mental health care .  3Ts believe that whilst in no way undermining the hard work and care offered by the excellent medical health care teams in our hospitals, it highlights the need for the provision of specialised Suicide and Self-Harm care services in EDs. Specifically, 3Ts believe this research highlights the need for a Mental Health Emergency Department which should run alongside every A&E in Ireland. This remains one of 3Ts’ main lobbying goals and we intend to pursue enhanced Emergency Mental Health services in our hospitals with  Government as per the findings of this study.

Phase I: International Academic Publication 

Published September 2026 in the International Journal of Mental Health Nursing  - Read Open Access Article here or download here. 

Phase II - Needs of Family / Supporting Adults 

Published in 2025, Phase II of this study focussed on The Experience & Support Needs of Family / Supporting Adults who Accompany Someone to the ED with Self-Harm, Suicide-Related Ideation or Suicide Attempt.  Learn more about Phase II here.  

Phase III - Experience of ED Staff

Commenced in 2026, Phase III of the study will focus on the Emergency Department Staff Experiences of Caring for Patients Presenting with Self-Harm and Suicidal Behaviour. More information to follow in due course.