Establishment and Evaluation of a Clinical Pathway for Young Suicide Attempters and Ideators

Abstract

Objective: To develop, implement and evaluate a pathway to care for young people presenting with suicidal ideation or deliberate self-harm. Methods: A working party consisting of key stakeholders was established to review existing practice, consider recommendations formulated in other centres, formulate a pathway, identify training needs for clinical staff, identify gaps in resources that would hinder the implementation of the pathway, and to evaluate effectiveness. Results: No existing pathways were identified that could be applied to the local context. A pathway was developed by consensus and disseminated to relevant clinical areas. A training strategy involving clinical placements was implemented. Critical gateway points along the pathway were identified and monitored. Compliance with gateway points was satisfactory, with the exception of review by a mental health clinician in the emergency department. More than 75% of young people presenting on the pathway attended community follow up, which is higher than the rate of compliance with follow up reported in most other studies. Conclusions: Establishing a clinical pathway permitted the delineation of roles and responsibilities. Although the pathway was developed for a local context, service planners may find it helpful to follow the steps in the pathway development process that have been outlined.