A one-day meeting was held in the Department of Psychiatry on Wednesday 16th April to mark the fact that at the end of 2025 the Oxford Self-harm Monitoring System had been in place, and continuously funded, for 50 years.
The Monitoring System involves data collection by clinical staff working in the Emergency Department at the John Radcliffe Hospital on all individuals who present with self-harm (self-poisoning or self-injury). This currently involves approximately 2,000 episodes per year. The data is used for a wide range of research projects, including within the Multicentre Study of Self-harm in England.
The Monitoring System was established as a research database by Emeritus Professor of Psychiatry, Keith Hawton, when he was a junior member of the Department in the 1970s. He directed this work until 2023, following which Professor Seena Fazel took over the leadership.
The anniversary meeting was attended in person by more than 50 participants, the majority of whom had had different roles in relation to the work of the system at various stages.
Head of the Department of Psychiatry at Oxford, Professor Belinda Lennox opened the meeting by welcoming everyone and highlighting the importance of the Monitoring System for research in the Department. Professor Sir Louis Appleby, who leads the National Suicide Prevention Strategy for England and the National Inquiry into Suicide and Safety in Mental Health, gave an account of the role of the research from the Monitoring System in relation to national policy regarding management and prevention of self-harm.
Professor Hawton presented a brief history of research on self-harm in Oxford and described how this was intimately related to the development of the Oxford self-harm service, initially at the Radcliffe Infirmary, where it was the first service of its kind in the UK to involve psychiatric nursing staff in front-line assessment and aftercare of patients who presented to the hospital with intentional self-poisoning or self-injury, and then subsequently at the John Radcliffe Hospital.
Clinical Staff working in the Emergency Department Psychiatric Service (Dr Jiaying Chan, Dr Albert Clifford, Fiona Brand, Dr Tiago Zortea) also reported on their experiences of collecting information for the research database, following which Professor Hawton reviewed a series of research achievements involving the database, including those that have been influential in terms of altering national policy in relation to suicide prevention (e.g. smaller packs of paracetamol, withdrawal of a highly toxic analgesic – both of which initiatives resulted in reduces numbers of poisoning deaths), and evidence that has informed national guidance on clinical management of self-harm.
Professor Hawton said:
When I first started this as a very junior researcher in the department, I couldn’t have envisaged the monitoring system still going 50 years later. Data collected and processed through the monitoring has played an extremely important role in identifying key drivers and outcomes of self-harm, and has had implications for policy and practice that has made a real difference to people’s lives, especially in terms of influencing clinical practice and reducing risk of self-harm and suicide. It has been a huge team effort over the years, with many people involved in this work that has also been important for both the Department and the Trust. I hope that it will continue to play these influential roles for many years to come.”
Professor Navneet Kapur, Research Director of the National Inquiry into Suicide and Safety in Mental Health at the University of Manchester, reviewed the role of the Oxford Monitoring System in the Multicentre Study of Self-harm in England, which was established 25 years ago in order to provide representative research information based on self-harm data collected in Oxford, Manchester and Derby.
Dr Anne Stewart, from the Department, and Professor Ellen Townsend, a former member of the Department and now based at Nottingham University, reviewed research studies based on self-harm data collected on children and adolescents. Finally, Keith Waters from Derby and Professor Ella Arensman from Cork in Ireland, a former member of the Department, presented reflections on collaboration with the Oxford research team. Professors Kapur and Hawton, together with Dr Tiago Zortea, who works in the Oxford Self-harm Service, and Dr Karen Lascelles, a psychiatric nurse who has both worked in the research team and the self-harm service, reflected on future needs for clinical care and research related to people who self-harm.
The day ended with a celebratory dinner at the Rose and Crown in Oxford. Professor Hawton thanked DPhil student Samantha Groves, working alongside Geri Campbell and Lauren Collins, for their help in organising the event.