Review into self harm incidents within Northamptonshire’s children’s mental health services will not be made public
There are often more than 50 incidents a month of young people harming themselves while in the care of mental health services
By Sarah Ward
A review into the number of self harm incidents happening in the county’s inpatient and self harm children and adolescent service will not be made public.
A thematic review was commissioned last year after concerns were raised about the frequency which young inpatients were harming themselves while in the care of Northamptonshire Healthcare Foundation Trust services.
The review looked at the ‘issue and management of young people requiring CAMHS psychiatric inpatient care unit (PICU) that are admitted to general CAMHS wards’. Despite having a significantly higher rate of self harm admissions than the national average the county does not have a PICU for young people and there is a national shortage of beds.
A report to its latest board meeting at the end of March said the review was in final stages of sign off and a paper was being written to look at the issues, however the board did not discuss the matter and NHFT has said the findings will not be made publicly available after an enquiry from NN Journal.
All that is being made public are a few details in the latest board paper which are hard to decipher without the context of the full report.
A statement given by NHFT to NN Journal said:
“As with any mental health service provider, the reduction of incidents of self-harm is a priority. In isolation self-harm incidents do not always individually meet the threshold for further investigation, however there was recognition a thematic review in CAMHS may identify any themes or similarities that once identified, could be addressed.
“A thematic review was therefore commissioned in February 2021 by the Internal Assurance Meeting (IAM). This is a weekly meeting attended by NHFT colleagues including safeguarding, patient safety, medical representation and other clinical staff.
“Reviews of this type consider many factors that may contribute to an incident. In order to maintain the privacy of individual patients, whose cases will form part of this review, as well as for the safety of all patients (for example avoiding revealing methods of self-harm), the thematic review will not be publicly available. Any learnings from the review will be within NHFT services.”
The number of self harm incidents that sparked the enquiry are not known because while reporting the monthly total of patient safety incidents reported across the entirety of its services, which includes physical healthcare for the elderly, the figure typically has not been broken down into incidents involving children.
However a board paper from last November, mentioned a notable increase that period in the number of self harm incidents reported within the CAMHS inpatient setting and did say there had been 66 incidents in both September and October last year.
And an earlier report to the board, which is chaired by Chrisi Waring, sheds more light on the issue, pointing to insufficient capacity to look after young people in acute distress.
“When discussed with the inpatient CAMHS service manager, it was identified that the needs of these patients would be more appropriately met by a psychiatric intensive care unit, however this is a recognised national shortage. In response to several self harm incidents being considered for further investigation, that in isolation did not meet the threshold for a formal investigation, a thematic review was instigated.”
At the start of this year board members were told:
“Closer inspection of the November and December data reveals a reduction in the number of self harm incidents reported within CAMHS inpatient settings, but are still more than would statistically be considered as typical variation. Closer interrogation of these incidents highlight that the vast majority are attributed to a small cohort of patients within CAMHS inpatients who are being supported in line with individualised care plans.”
Multiple self harm attempts by the same young people are mentioned throughout the NHFT patient safety reports written over the past twelve months.
According to the current 2019 report about mental health services from the Northamptonshire Clinical Commissioning Group, the rate of self harm admissions in Northants is well above most other areas.
“Locally rates of self-harm admissions are increasing in all ages and in Northamptonshire it is significantly higher than the England average. Local analysis has shown the rate of hospital admissions as a result of self-harm in those aged 10 to 24 years in the proposed North and West Northamptonshire areas are not significantly different from one another (695 per 100,000 population in North Northamptonshire and 760 per 100,000 populations in West Northamptonshire).
“However this masks inequalities within each area; those living in the most deprived areas of Northamptonshire are 3.9 times more likely to be admitted to hospital from self-harm than those in the least deprived areas. Indeed if the most deprived 20 per cent of the population had the same rate of hospital admissions for self-harm as the least deprived areas there would be approximately 163 less admissions a year in the most deprived areas.”
There has been a huge rise in the numbers of children being referred to mental health services following the pandemic. Read this recent Guardian report about the crisis within CAMHS services across the country.
If you have personal experience of the CAMHS service in Northamptonshire you can call Sarah Ward on 07887 500545 for a conversation in confidence.
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