Self-harm: what the Public Health Agency says we can’t be told

We do not know which patients were given a Card Before You Leave appointment

We do not know which patients were given a Card Before You Leave appointment

By Kathryn Torney

THE Public Health Agency has claimed that a “software reporting error” means that it cannot release data from the NI Registry of Deliberate Self-Harm relating to the high profile Card Before You Leave (CBYL) Scheme.

This is just one of the many pieces of important information withheld from us. We also have not been told the gender of each individual presenting at emergency departments with self-harm or thoughts of suicide over a three-month period last year.

The agency claims revealing whether an anonymous case involves someone who is male or female may lead to their confidentiality being compromised.

CBYL provides a next day mental health follow-up service for patients who attend an emergency department with self-harm or thoughts of suicide and who have been identified as low risk to themselves or others. They should receive a card prior to discharge which gives details of their follow-up care and contact numbers for support.

We were only told about the “reporting issue” following an internal review we requested of the agency’s handling of our Freedom of Information request.

It was only then made clear that the CBYL information was not being withheld using Freedom of Information exemptions and instead could not be accessed due to a computer error.

A spokeswoman said: “Once the (CBYL) data is available to the registry team, it will be looked at in the context of the information that has already been provided to you with a view to establishing whether it can be reasonably placed in the public domain.”

When asked to comment further on the software error, a spokesman for the Public Health Agency said that the registry team is “examining this issue with key stakeholders”.

A simple ‘yes’ or ‘no’ should be recorded in the CBYL column for each self-harm episode. Instead, the spreadsheet we have been given reads “#NULL!” in every cell.

As part of an internal review of our FOI request, we argued that an explanation was needed for codes used in the data including those relating to patients’ gender, whether patients were seen by a doctor and whether or not they were admitted to a ward.

We feel this would not risk patients’ confidentiality – as no exact dates, names, exact ages, hospital name or trust area have been provided. The month of the hospital admission is not even included.

All of this information has been withheld from us despite Health Minister Edwin Poots stating in response to an Assembly question that the registry collates only “anonymised data”. No identifiable client information is recorded or used in the registry.

However, an FOI internal review carried out by the PHA confirmed its original decision not to provide information on this coding.

The response included: "If the PHA were to provide the information sought there is a very real likelihood that individual service users will be identified.

“This would breach the PHA duty of confidence to those individuals and the PHA’s obligations under the Data Protection Act by contravening data protection principles.

“This is particularly so given the vulnerable nature of this group of patients who will have attended emergency departments as a result of self harming episodes. The identification of such individuals may well lead to further episodes of self harm.”

In a later response, we were also told: “Although you assert that the data fields in themselves may not allow identification of an episode, they can, in conjunction with other fields, allow context and circumstance to be drawn from the data as a whole, which is of significant concern to the Public Health Agency as we are committed to maintaining the privacy of individuals.”

However, the review did reveal for the first time that other column headings had been withheld from us – including whether or not each patient had received a psychiatric assessment in the accident and emergency department. Also withheld was the time and weekday of each hospital admission – which could provide evidence, for example, of many self-harm admissions occurring at weekends or during the night.

The information released to us covers only the first quarter of 2012 (April to June). We were told weeks ago that the second quarter had been prepared and would be released to us “as soon as possible” but we are still waiting.


:: Lifeline is the Northern Ireland crisis response helpline service for people who are experiencing distress or despair. It can be contacted confidentially on 0808 808 8000 or go to

:: The PHA mental health promotion website is at:

:: The Samaritans can be contacted by telephone on 08457 90 90 90 or email [email protected]