@article{ref1,
title="Impact of national policy initiatives on fatal and non-fatal self-harm after psychiatric hospital discharge: time series analysis",
journal="British journal of psychiatry",
year="2012",
author="Gunnell, David and Metcalfe, Chris and While, David and Hawton, Keith E. and Ho, Davidson and Appleby, Louis and Kapur, Nav",
volume="201",
number="3",
pages="233-238",
abstract="BACKGROUND: Risk of self-harm and suicide is greatly increased in the period after discharge from psychiatric in-patient care. AIMS: To investigate the impact on suicide of a series of policy initiatives to enhance care in the immediate post-discharge period. METHOD: A time series analysis was based on 1997-2007 data from the National Confidential Inquiry into Suicide and from Hospital Episode Statistics for England. RESULTS: There was no evidence of a reduced risk of suicide in the first 12 weeks following discharge in 2003-2007 compared with 1997-2002. In contrast, the relative risk of non-fatal self-harm in the 12 weeks after discharge declined. The risk ratio for self-harm (2003-2007 v. 1997-2002) at 0-1 week post-discharge was 0.86 (95% CI 0.80-0.92) and at 2-4 weeks it was 0.89 (95% CI 0.85-0.94). CONCLUSIONS: These findings provide some support for the impact of recent policy changes on the risk of non-fatal self-harm in the immediate period after discharge from psychiatric in-patient care.<p /> <p>Language: en</p>",
language="en",
issn="0007-1250",
doi="10.1192/bjp.bp.111.104422",
url="http://dx.doi.org/10.1192/bjp.bp.111.104422"
}