"Accessing Help for Self-Harm & Suicidal Behaviour in ED - Families & Companions" Phase 2 Research Underway13/10/2022
Recruitment now closed for participants for research phase 2 "Accessing Help for Self-Harm & Suicidal Behaviour in ED - Families & Companions"
Research project funded by 3Ts and Irish Research Council "New Foundations" Grant Award
Recruitment of participants is now closed for Phase 2 of our research "Accessing Help for Self Harm & Suicidal Behaviour in the Emergency Department. Researchers at the Trinity College School of Nursing and Midwifery are now commencing analysis of the data gathered via an online survey process.
The team recruited volunteers aged 18 years +, who accompanied someone to the Emergency Department in the Republic of Ireland with self-harm, suicidal behaviour or a suicide attempt within the past 5 years and not more than 2 months ago. Volunteers were asked to participate in our survey taking place over the course of summer / Autumn 2022.
Follow-up to Phase 1 "Accessing Help for Self Harm & Suicidal Behaviour in the ED: Experiences of Service Users’
This is a follow on to Phase 1 which completed in 2020 and focused on the personal experiences of 50 participants who presented to the ED of hospitals throughout Ireland for self-harm or suicidal behaviour within the preceding 5 years. You can view or download the full Phase 1 Research Report by clicking on the image below.
Phase 2 focuses on families and companions who have shared their experiences of accompanying someone to the ED with self-harm, suicidal behaviours or an attempted suicide.
Aim of Phase 2
We hope to identify what experiences family members/companions have when they accompany someone to the ED with self-harm/suicidal behaviour. We're also looking to identify what are the support needs of family members/companions .
Researchers have gathered this information via on anonymous, online exploratory survey. The survey comprised 30 questions in total - not every question relevant to every participant - and comprised a mix of short, closed questions, and more open-ended questions which provide more of an opportunity for participants to describe their experiences.
PARTICIPATION IS ANONYMOUS
The survey is anonymous. Any information provided in the responses that could be identifiable will be removed in the survey report.
This study was granted ethical approval from the Research Ethics Committee of the Faculty of Health Sciences, Trinity College Dublin.
Phase 1 Key Findings & Recommendations
A key finding of Phase 1 was that there was a lot of variability in the experiences people had with many participants reporting poor experiences overall while a smaller group had mostly positive experiences.
Poor patient experiences often occurred because of a lack of understanding from ED staff around self-harm/suicidal ideation. This lack of understanding contributed to negative interactions and treatment including ‘labelling’ and treating the person as ‘different’ from those presenting with physical health problems. This created a sense of ‘otherness’ which stigmatised individuals and further compounded low self-esteem for some. Other negative aspects of care and treatment in the ED included mechanistic, ‘tick-box’ mental health assessments, a lack of information and onward referral at discharge and a lack of follow-up following discharge.
However, while negative experiences were not uncommon, there were some very positive experiences reported also where participants reported interacting with empathetic, skilled, and knowledgeable staff who included them and their families in the assessment and treatment process. These positive experiences were common when interacting with specialist mental health staff, although this was not exclusively the case.
Bring a companion
One of the key findings that also came from this study was around the issue of being accompanied or not to the ED. Approximately one-third of participants in this study did not have anyone with them when they presented to the ED. These participants generally found the experience more difficult and found the long waiting time, in an often noisy and chaotic environment, distressing and lonely and were consequently more inclined to leave the ED without being seen. Those who had people with them reported that it was often family members/friends who encouraged them to stay and be assessed and for the most part their presence in the ED was very valuable to them.
However, it was also clear that family members/companions were often left unsupported by staff when they were in the ED and crucially also when the person was discharged home. Participants described how companions were sometimes not included in their assessment, despite this being an important aspect of the guidance around assessment of a person following self-harm or a suicide attempt in the ED. In other cases, participants reported how their family members were left to care for them at home while waiting on a referral to mental health services, with no information on how best to help and support their loved one in this difficult time. Consequently, a key recommendation that emerged from this was study was to engage in further research on the experiences and support needs of family members/companions who support someone presenting to the Emergency Department following self-harm/suicidal behaviour. Phase 2 of our emergency department research will focus on this topic.