DSH Liaison Nurse
Service
Louth/Meath Mental Health Services
Philosophy of Service
National task force on suicide (1998) “every case of
parasuicide be examined by the liaison psychiatric
team and that each team nominate a health care
professional to oversee the future management of
these individuals”…
Suicide in Ireland (2001) “specific attention to be paid
to those who deliberately self harm (DSH)”…
To provide psycho-social assessment to individuals
who have been been admitted to the Louth County
Hospital with DSH.
To achieve anti-discriminatory practice while working
actively to contribute to a better understanding of DSH
and to provide a service which conveys respect for the
dignity and worth of each individual assessed and their
families.
Of known risk factors DSH has strongest association
with suicide
Goals and Objectives
To offer a priority response to requests for assessment to
clients admitted to the Louth county hospital following
DSH on a Monday to Friday basis
To offer relatives and friends the opportunity to speak to
the dedicated professional
To ensure the completion of a comprehensive risk
assessment and liaison and referral on to appropriate
agencies
To co-ordinate follow-up and after care plans
Aim to form link for future help, screen for psychiatric
disorders; Assess safety/risk; Use scaling questions; Offer
an opportunity to have story validated and focus on
strengths, past coping and clarify future options and
vision
Today’s Situation
Critical point in someone's life – can be used as
a TURNING POINT
Patients want conversation and not Q & A
session
Not a problem saturated assessment but a
conversation that is in itself useful i.e.
Normalise, safety plans, exception questions,
generate possibilities, use existing support
Diverse nature of group – drop out common
Collaboration is key
Work with Drs and MSE and use MDTM mtg
Use recognised assessment tools
Incorporate psychiatric nursing skills in one- toone and family work
Initial Assessment Meeting.








Set Appointment for fixed time.
Offer relatives and friends time
Contract for 4- 6 sessions initially
Client to set agenda
Set Safety plan in place
Focus on existing strengths and abilities
Liaison with the community mental health team
E.g. Psychiatrist, Affective disorder team, CPN,
Alcohol Counsellor and the clients GP.
DSH Liaison Nurse Service Statistics 2002
Totals
Male
45
Laceration
13
Female
60
Drugs
9
Times Seen
291
Asphyxiation
2
Hx DSH
45
Other
35
Psych Hx
35
Louth
97
Unemployed 30
Monaghan
8
Overdose
70
Pts Seen in LCH
80
Alcohol
41
DNA’S
55
What Have We Learned?
Diverse client group – live chaotic lives
Difficult to engage with high drop-out from
services
Able to see people at the heart of their crisis – not
useful to have appointments in 2-3 weeks time
Vital for recognising signs that could prevent
future crisis
Suicide is often a means towards an end rather
than an end itself
Overwhelming sense of embarrassment leads to
added vulnerability
Staff in LCH positive about role
Recommendations
18 months on:
Assessed 174 people. Further 20 people @ 28.02.03
Follow-up plans agreed with over 80%
Engagement better if seen in LCH
Most common presenting difficulties include: alcohol
abuse;Situational crisis; Inter-personal difficulties
Comments include: want time to be heard;Choices re:
follow-up, opportunity for family to be involved; Not
blanket clinic attendance; Possibility for future access and
support
Need for audit/research to facilitate a better
understanding of DSH
Development of protocols and policies
Share information and experiences of this pilot project
THANK
YOU