BMJ  2005;331:966 (22 October), doi:10.1136/bmj.331.7522.966-c

Letter

Postcards from the edge

Homelessness poses extra challenge in reducing self harm

The first 150 words of the full text of this article appear below.

EDITOR—The idea of using postcards to reduce repetition of deliberate self harm is good,^{1 2} but it cannot be delivered to the entire population of those who self harm.

We looked at the incidence of deliberate overdose in our population of homeless patients from 1999 to 2003. There were 177 episodes in 116 patients, out of a population of 1617. This translated to an incidence of 7.2%, higher than that in the general population.

Taking an overdose, and other forms of self harm, are more common in homeless people, many of whom have multiple illness. Some can be followed up through support workers, while others remain chaotic and at risk. Postcards and text messages may help some to make contact, but others will remain uncontactable. At the very least, it helps when emergency departments or liaison psychiatry inform primary care providers—but this practice is patchy, to say the least.

NFA Health Centre, Leeds LS9 8AA sallylread@btinternet.com

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. . . [Full text of this article]

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