Manchester Mental Health and Social Care Trust - Services - Help in a crisis - SAFE Team (Self-Harm, Assessment, Follow-up and Engagement)

SAFE Team (Self-harm, Assessment, Follow-up and Engagement)

The SAFE Team (Self-Harm, Assessment, Follow-up and Engagement) is a nurse led evidence-based service. The main function of the service is to assess and where appropriate meet the mental health and social care needs of those residents of Manchester who have self-harmed, in a way that is respectful of culture, gender, individual difference and choice.

Who is it is for?

·People between the ages of 16 and 65 who present to A&E at Manchester Royal Infirmary with any form of intentional self-harm, or who have been referred by other health professionals
·People registered with a Central Manchester GP and reside in the City of Manchester or who are not registered with a GP but who live within the catchment area of Central Manchester ('In Area').

Assessment

The Team provides rapid ward based assessments for people admitted from A&E as a result of self-harm. We also provide follow up for people that have attended A&E but have not received an assessment from a Mental Health Practitioner and those that have discharged themselves. We endeavour to make contact within 24 to 72 hours of presentation to offer an appointment, targeting a group of people who traditionally would not receive a service and are at increased risk of suicide. A comprehensive psycho-social mental state examination and self-harm and suicide risk assessments are completed and a management plan agreed.

Follow-up/ Therapy

We offer four sessions of Psychodynamic Interpersonal Therapy (PIT) to help clients explore alternative ways of managing difficult feelings. Sessions are offered in the Rawnsley Building at the Central Manchester Hospitals site or in the client's home, it is their choice. The intervention is an adaptation of Hobson's (PIT), also known as the Conversational Model, and is offered to those client's experiencing interpersonal difficulties. The model uses the client-therapist relationship as a tool for resolving interpersonal issues.

PIT has been found to have effects equivalent to cognitive behavioural therapy for the treatment of depression and emphasises a strong working alliance. Key aspects include picking up cues, staying with feelings and working in the here and now. The therapist adopts a negotiating style and is open to correction as the intention is to engage the patient in a conversation, or a "shared feeling language" which moves gradually to deeper and deeper levels. Metaphor is used wherever possible to link images to underlying feelings. Statements are preferred to questions and are couched in the form of hypotheses. These are tentative but informed guesses that the therapist makes about the client's inner world.

Emphasis is placed upon exploring feelings, and bringing up these into the 'here and now'. The problems, which have precipitated the self-harm, are explored and a rationale linking feelings, problems and relationships is developed.

Liaison

The Team liaises with clients, GPs and other services to ensure consistent care, negotiate a final management plan and organise further support as necessary.

Regardless of the patients age and status, the SAFE Team will inform the GP of the self-harm episode and the outcome.

Teaching

The Team offer training in self-harm, assessment, management and treatment to nursing and medical staff and students. We also provide workshops for both statutory and non-statutory organisations as well as offering supervision and general support and advice.

Additional Support / Helpful Information

http://www.thecalmzone.net/

http://www.mind.org.uk/

http://www.nshn.co.uk/

http://www.papyrus-uk.org/

http://www.samaritans.org.uk/

http://www.sane.org.uk/

http://www.selfhelpservices.org.uk/

http://www.studentdepression.org/