Monitoring deliberate self-harm presentations to general hospitals

Monitoring of deliberate self-harm (DSH) presentations to hospitals (and in other settings) is receiving increased attention in many countries. This is due to greater recognition of the size of the problem and awareness of its relevance to suicide prevention policy initiatives, because of the strong association between DSH and suicide. A system for monitoring all DSH presentations has been in place in the general hospital in Oxford for 30 years. Based on our experience, in this paper we describe procedures for monitoring, including case definition and identification, linkage of persons and episodes in order to investigate repetition of DSH and other outcomes (including deaths), and data protection and ethical issues. We also provide details of how to carry out monitoring, including different models of data collection, and what data to collect. Finally we consider the potential uses of the data for both clinical and research purposes, including evaluation of national suicide prevention initiatives.     

Policy,Practicalities, and PACE s. 24: The Subsuming of the Necessity Criteria in Arrest Decision Making by Frontline Police Officers

PACE, as amended by the Serious Organised Crime and Police Act 2005, establishes a complex framework of factors that police officers must consider during arrest decision making. Officers must possess a reason to arrest, it must be necessary to arrest for that reason, and they must give at least a ‘cursory consideration’ to alternatives. Based on a four‐year ethnographic study of frontline officers from two forces in Northern England, we argue that the 2005 reforms have not achieved their aims. The new regime tasks officers with undertaking a complex legal assessment prior to arrest, but officers are often confused about the necessity criteria which, moreover, is typically a minor consideration in contrast to demanding practical and policy pressures. This means that unlawful and non‐human‐rights‐compliant arrests continue to be regularly made and, equally significantly, many suspects are escaping the criminal justice system because officers are not considering arrest alternatives.