Agenda item

Report of the Director of Public Health

The Committee received a report on the self-harm hospital admissions during 2014/15. National research shows that self-harm rates are higher among children and young people and are four times higher for girls than boys. It was noted that certain groups of young people are more vulnerable to self-harm, including; children and young people in residential settings, lesbian, gay, bisexual and transgender young people, Asian young women and children and young people with learning disabilities.

The Child Health Profile shows that in 2014/15 179 young people aged 10-24 years were admitted to hospital as a result of self-harm. This is a reduction from 2013/14 where the figure was 214. It was reported that Gateshead is higher than the Newcastle and the North East in terms of self-harm rates.

An analysis of data from North East Commissioning Support showed that in 2015/16 overall the admission rates for females is higher than males, however the trend for female admissions is down in  this year. During 2015/16 there was an increase in the number of male admissions in the age group 10-24, however it was pointed out that within that group there were two males who had over 10 admissions each which may have skewed the data

In relation to the intentional self-harm during 2014/15 and 2015/16 the majority of female admissions were coded by the hospital as self-poisoning with medicine. There was also 37 females coded as self-harm by sharp object. In the same period for males the majority of admissions were coded as self-poisoning by exposure to drugs used to treat epilepsy, tranquilisers or medicines that alter chemical levels in the brain. There was also six male admissions coded as self-harm by sharp object. It must be noted that the 2015/16 data from North East Commissioning support has not yet been validated so must be treated with caution at this time.

It was reported that the causes for concern forms passed from the Queen Elizabeth Hospital to children’s services are low compared to the number of hospital admissions. In 2014/15 there were 77 forms passed to children’s services, against a total of 179 admissions, in 2015/16 there were 83 forms passed over against a potential total of 223 admissions. It was acknowledged that  there are potential  issues around coding and work is ongoing to improve this for the future.

It was noted that there is a full review ongoing in the Child and Adolescent Mental Health Service and work is underway with the CCG to cross reference hospital data.

In order to address the issue of self-harm, training has been delivered to schools over three sessions and has been well attended by all secondary schools. It was pointed out that schools had previously raised the issue of how to support young people who are self-harming. It was reported that the Gateshead Self-Harm Protocol has been developed to help professionals identify and support children and young people who are self-harming.  It is anticipated that this will be rolled out to GP’s, School Nurses and A&E staff in the near future.

It was reported that the Schools Health and Wellbeing Survey has been developed for schools to sign up to and now includes questions around self-harm.

It was questioned whether the training around self-harm would be expanded to primary schools in the future. It was confirmed that currently the training is offered to secondary schools through designated safeguarding leads, with five or six staff from each school attending. It was noted that discussions are ongoing around the roll out of the training to other professional groups and that primary schools can be looked at as an option. It was confirmed that mindfulness work is in place for primary school pupils, this helps to promote the resilience of children and young people.

It was queried as to the age range of the children taking part in the Health and Wellbeing Survey. It was noted that currently this is for children in years four to six and years eight to 10, however this age range could be extended if requested.

It was questioned whether there are any links between the number of young people self-harming and the cuts in services, for example youth services. It was acknowledged that there is a need for better understanding as to whether there are links with other services as currently there is only reporting on hospital admissions.

A  point was raised  that different activities resulting in self-harm (ie. Taking pills versus cutting) could be viewed as more or less immediately harmful by degree. It was clarified that self-harm can be defined in a number of ways including “intentional self-poisoning or injury, irrespective of the purpose or act”. It was also noted that better understanding is needed around the male’s with repeat admissions.

It was questioned as to how many admissions were from young people who are waiting for appointments with CAMHS. It was noted that this will be looked at.

RESOLVED    -           (i)         That the comments of the Committee on the

information provided be noted.

                                    (ii)        That the Committee agreed that further work should be

undertaken by Public Health, Children’s Services and North East Commissioning Support to look at the coding of admissions, the cause for concern forms that are sent to children’s services to gain a fuller picture of the issues and the differences in the data.

                                    (iii)       That the Committee agreed to receive an update in 12

months in relation to:

·         The implementation of the Self-Harm Protocol

·         The findings of the Schools Health and Wellbeing Survey

·         The new model for CAMHS and the implications and outcomes for children and young people