Systematic Review and Quality Appraisal of Practice Guidelines for Self‐Harm in Children and Adolescents

This study aimed to systematically identify and appraise clinical practice guidelines ( CPG s) relating to the assessment and management of suicide risk and self‐harm in children and adolescents. Our research question is as follows: For young people (under 18 years old) presenting to clinical care with suicide ideation or a history of self‐harm, what is the quality of up‐to‐date CPG s? Using the PRISMA format, we systematically identified CPG s meeting our inclusion and exclusion criteria. Subsequently, two independent raters conducted appraisals of the eligible CPG s using the Appraisal of Guidelines for Research and Evaluation II instrument. CPG s were then classified as “poor quality,” “minimum quality,” and “high quality” using operationally defined criteria developed a priori. We identified 10 eligible CPG s published or renewed between 2005 and May 2017. Only the long‐term management of self‐harm CPG s produced by the National Institute for Health and Care Excellence met “high‐quality” criteria. Despite multiple options of CPG s published to choose from, only one was identified as “high quality,” where bias is adequately minimized. Clinicians are advised to direct resources to implementing the “high‐quality” CPG .