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<p>Data on the number of finished admission episodes for self harm for 0 to 17 year
olds for the years 2003-04 to 2012-13 is in the following table.</p><p> </p><p> </p><p>
</p><table><tbody><tr><td colspan="7"><p>Count of finished admission episodes (FAEs)<sup>1</sup>
with a cause code of self harm<sup>2</sup> for patients aged 0-17 for the years 2003-04
to 2012-13<sup>3</sup></p></td></tr><tr><td> </td><td> </td><td> </td><td> </td><td>
</td><td> </td><td> </td></tr><tr><td colspan="6"><p>Activity in English NHS Hospitals
and English NHS commissioned activity in the independent sector</p></td><td> </td></tr><tr><td><p>Year</p></td><td><p>FAEs</p></td><td>
</td><td> </td><td> </td><td> </td><td> </td></tr><tr><td><p>2003-04</p></td><td><p>11,404</p></td><td>
</td><td> </td><td> </td><td> </td><td> </td></tr><tr><td><p>2004-05</p></td><td><p>11,402</p></td><td>
</td><td> </td><td> </td><td> </td><td> </td></tr><tr><td><p>2005-06</p></td><td><p>13,054</p></td><td>
</td><td> </td><td> </td><td> </td><td> </td></tr><tr><td><p>2006-07</p></td><td><p>12,980</p></td><td>
</td><td> </td><td> </td><td> </td><td> </td></tr><tr><td><p>2007-08</p></td><td><p>13,785</p></td><td>
</td><td> </td><td> </td><td> </td><td> </td></tr><tr><td><p>2008-09</p></td><td><p>12,934</p></td><td>
</td><td> </td><td> </td><td> </td><td> </td></tr><tr><td><p>2009-10</p></td><td><p>12,944</p></td><td>
</td><td> </td><td> </td><td> </td><td> </td></tr><tr><td><p>2010-11</p></td><td><p>13,995</p></td><td>
</td><td> </td><td> </td><td> </td><td> </td></tr><tr><td><p>2011-12</p></td><td><p>13,231</p></td><td>
</td><td> </td><td> </td><td> </td><td> </td></tr><tr><td><p>2012-13</p></td><td><p>14,780</p></td><td>
</td><td> </td><td> </td><td> </td><td> </td></tr><tr><td colspan="5"><p><em>Source</em>:
Hospital Episode Statistics (HES), Health and Social Care Information Centre</p></td><td>
</td><td> </td></tr><tr><td> </td><td> </td><td> </td><td> </td><td> </td><td> </td><td>
</td></tr></tbody></table><p> </p><p>This data should not be interpreted as a count
of people as the same person may have been admitted on more than one occasion. Reference
should be made to the notes when interpreting the data.</p><p> </p><p> </p><p> </p><p>The
Government is committed to reducing self-harm.</p><p> </p><p> </p><p> </p><p>The Mental
Health Action Plan, <em>Closing the Gap: Priorities for Essential Change in Mental
Health</em> (January 2014), sets out 25 of the most important changes that we want
the National Health Service and social care to make in the next few years to improve
the lives of people with mental health problems and help reduce health inequalities.
It highlights how we will change the way frontline health services respond to self-harm.</p><p>
</p><p> </p><p> </p><p>In the revised Public Health Outcomes Framework, we have introduced
a new indicator that is specifically about self-harm. Under this indicator, we will
measure:</p><p> </p><p>- attendances at emergency departments for self-harm per 100,000
population;</p><p> </p><p>- percentage of attendances at emergency departments for
self-harm that received a psychosocial assessment.</p><p> </p><p> </p><p> </p><p>This
two-part indicator helps us not only understand the prevalence of self-harm but also
how emergency departments are responding. This information can then inform future
commissioning.</p><p> </p><p> </p><p> </p><p>The National Institute for Health and
Care Excellence (NICE) guidelines make it clear that anyone who attends an emergency
department for self-harm should be offered a comprehensive assessment of their physical,
psychological and social needs. In 2004, NICE published a clinical guideline on self-harm.
This covered the short-term physical and psychological management and secondary prevention
of self-harm in primary and secondary care. It sets out the care people who harm themselves
can expect to receive from healthcare professionals in hospital and out of hospital;
the information they can expect to receive; what they can expect from treatment and
what kinds of services best help people who harm themselves. Following on from this
guideline, in November 2011, NICE issued a clinical practice guideline on the longer-term
management of self-harm.</p><p> </p><p> </p><p> </p><p>We expect general practitioners
to refer people who disclose self-harm for psychological support as appropriate. We
are investing £54 million over the period 2011 – 2015-16 in the Children and Young
People’s Improving Access to Psychological Therapies (CYP IAPT) programme which is
giving children and young people improved access to the best evidenced mental health
care. This includes Interpersonal Psychotherapy for Adolescents and Cognitive Behavioural
Therapy for emotional disorders such as anxiety and depressive disorders, Obsessive
Compulsive Disorder (OCD) and Post Traumatic Stress Disorder.</p><p> </p><p> </p><p>
</p><p><em>Achieving Better Access to Mental Health Services by 2020</em> contains
the first waiting time standards for mental health.</p><p> </p><p> </p><p> </p><p>It
announces the introduction of improved investment in specialist intensive psychiatric
mental health facilities for children and young people to reduce waiting times for
intensive psychiatric care and to end the practice of young people being admitted
to mental health beds far away from where they live or from being inappropriately
admitted to adult wards. It announces the introduction of standard waiting times for
Early Intervention in Psychosis services which will be of benefit to young people,
and for the adult Improving Access to Psychological Therapies (IAPT) programme. It
makes it clear that the waiting time standards announced are a first step. There will
also be £30 million increased investment in liaison psychiatry to help people including
young people presenting in accident and emergency departments with mental health problems.
The vision is for comprehensive standards to be developed over the coming years for
all ages, including for children and young people. However, where adult IAPT services
are commissioned to provide a service to 16 and 17 year olds, the waiting time standard
will apply to all those attending the service, regardless of their age.</p><p> </p><p>
</p><p> </p><p><em>Preventing suicide in England: A cross-government outcomes strategy
to save lives</em> was published on 10 September 2012 to coincide with the International
Association for Suicide Prevention’s World Suicide Prevention Day.</p><p> </p><p>
</p><p> </p><p>The Department, through the National Institute for Health Research
and the Policy Research Programme has invested significantly in mental health research
and will continue to support high-quality research on suicide, suicide prevention
and self-harm.</p><p> </p><p> </p><p> </p><p>The Suicide Prevention Strategy, <em>Preventing
suicide in England: A cross-government outcomes strategy to save lives</em> is backed
by £1.5 million funding, through the Policy Research Programme, which is supporting
six projects to help us better understand key aspects of suicide and self-harm, including
looking at self-harm in young people and the role of the internet and social media.</p><p>
</p><p> </p><p> </p><p>The new e-portal – MindEd – launched in March 2014 includes
content on self-harm, suicide and risk in children and young people.</p><p> </p><p>
</p><p> </p><p><em>Notes</em></p><p> </p><p><sup>1</sup>Finished admission episodes.
A finished admission episode (FAE) is the first period of inpatient care under one
consultant within one healthcare provider. FAEs are counted against the year in which
the admission episode finishes. Admissions do not represent the number of inpatients,
as a person may have more than one admission within the year.</p><p> </p><p> </p><p>
</p><p><sup>2</sup>Cause Code. A supplementary code that indicates the nature of any
external cause of injury, poisoning or other adverse effects. Only the first external
cause code which is coded within the episode is counted in HES. The cause codes used
to identify episodes of self harm were:</p><p> </p><p> </p><p> </p><p>A supplementary
code that indicates the nature of any external cause of injury, poisoning or other
adverse effects. Only the first external cause code which is coded within the episode
is counted in HES.</p><p> </p><p> </p><p> </p><p>The cause codes used to identify
episodes of self harm were:</p><p> </p><p> </p><p> </p><p>X60 – Intentional self-poisoning
by and exposure to nonopioid analgesics, antipryretics and antirheumatics</p><p> </p><p>X61
– Intentional self-poisoning by and exposure to antiepileptic, sedative-hypnotic,
antiparkinsom and psychotropic drugs, note elsewhere classified</p><p> </p><p>X62
– Intentional self-poisoning by and exposure to narcotics and psychodysleptics [hallucinogens],
not elsewhere classified</p><p> </p><p>X63 – Intentional self-poisoning by and exposure
to other drugs acting on the automatic nervous system</p><p> </p><p>X64 – Intentional
self-poisoning by and exposure to other and unspecified drugs, medicaments and biological
substances</p><p> </p><p>X65 - Intentional self-poisoning by and exposure to alcohol</p><p>
</p><p>X66 - Intentional self-poisoning by and exposure to organic solvents and halogenated
hydrocarbons and their vapours</p><p> </p><p>X67 - Intentional self-poisoning by and
exposure to other gases and vapours</p><p> </p><p>X68 - Intentional self-poisoning
by and exposure to pesticides</p><p> </p><p>X69 - Intentional self-poisoning by and
exposure to other and unspecified chemicals and noxious substances</p><p> </p><p>X70
– Intentional self-harm by hanging, strangulation and suffocation</p><p> </p><p>X71
- Intentional self-harm by drowning and submersion</p><p> </p><p>X72 - Intentional
self-harm by handgun discharge</p><p> </p><p>X73 - Intentional self-harm by rifle,
shotgun and larger firearm discharge</p><p> </p><p>X74 - Intentional self-harm by
other and unspecified firearm discharge</p><p> </p><p>X75 - Intentional self-harm
by explosive material</p><p> </p><p>X76 - Intentional self-harm by smoke, fire and
flames</p><p> </p><p>X77 - Intentional self-harm by steam, hot vapours and hot objects</p><p>
</p><p>X78 - Intentional self-harm by sharp object</p><p> </p><p>X79 - Intentional
self-harm by blunt object</p><p> </p><p>X80 - Intentional self-harm by jumping from
a high place</p><p> </p><p>X81 - Intentional self-harm by jumping or lying before
moving object</p><p> </p><p>X82 - Intentional self-harm by crashing of motor vehicle</p><p>
</p><p>X83 - Intentional self-harm by other specified means</p><p> </p><p>X84 - Intentional
self-harm by unspecified means</p><p> </p><p> </p><p> </p><p><sup>3</sup>Assessing
growth through time (Admitted patient care).</p><p> </p><p>HES figures are available
from 1989-1990 onwards. Changes to the figures over time need to be interpreted in
the context of improvements in data quality and coverage (particularly in earlier
years), improvements in coverage of independent sector activity (particularly from
2006-07) and changes to NHS practice). For example, apparent reductions in activity
may be due to a number of procedures which may now be undertaken in out-patient settings
and so no longer include in admitted HES patient data. Conversely, apparent increases
in activity may be due to improved recording of diagnosis or procedure information.
Note that Hospital Episode Statistics (HES) include activity ending in the year in
question and run from April to March, eg 2012-13 includes activity between 1 April
2012 and 31 March 2013.</p><p> </p><p> </p><p> </p>
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