Global prevalence of psychosocial assessment following hospital-treated self-harm: systematic review and meta-analysis

Journal article

BACKGROUND: Hospital-treated self-harm is common, costly and associated with repeated self-harm and suicide. Providing a comprehensive psychosocial assessment following self-harm is recommended by professional bodies and may improve outcomes. AIMS: To review the provision of psychosocial assessments after hospital-presenting self-harm and the extent to which macro-level factors indicative of service provision explain variability in these estimates. METHOD: We searched five electronic databases to 3 January 2023 for studies reporting data on the proportion of patients and/or events that were provided a psychosocial assessment. Pooled weighted prevalence estimates were calculated with the random-effects model. Random-effects meta-regression was used to investigate between-study variability. RESULTS: 119 publications (69 unique samples) were included. Across ages, two-thirds of patients had a psychosocial assessment (0.67, 95% CI 0.58-0.76). The proportion was higher for young people and older adults (0.75, 95% CI 0.36-0.99 and 0.83, 95% CI 0.48-1.00, respectively) compared with adults (0.64, 95% CI 0.54-0.73). For events, around half of all presentations had these assessments across the age range. No macro-level factor explained between-study heterogeneity. CONCLUSIONS: There is room for improvement in the universal provision of psychosocial assessments for self-harm. This represents a missed opportunity to review and tailor aftercare supports for those at risk. Given the marked unexplained heterogeneity between studies, the person- and system-level factors that influence provision of psychosocial assessments after self-harm should be studied further

Authors: Witt, K; McGill, K; Leckning, B; Hill, NTM; Davies, BM

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: Cambridge University Press
• Journal: BJPsych Open
• Volume: 10
• Issue: 1
• Pages: e29-e29
• Article number: e29
• Publication date: 2024-01-11
• DOI: 10.1192/bjo.2023.625
• EISSN: 2056-4724
• ISSN: 2056-4724
• Language: English
• Keywords: Harm; Study heterogeneity; Demography; Psychosocial; Internal medicine; Psychology; Clinical psychology; Medicine; Psychiatry; Meta-analysis