Self-harm Mental and Behavioural Disorders
Conditions
Interventions
Current interventions as of 07/02/2024:
Participants allocated to the ASsuRED arm will be offered a therapeutic assessment, enhanced safety planning and three follow-up appointments with the same prac
Sponsors
Devon Partnership NHS Trust
City, University of London
Eligibility
Sex/Gender
All
Age
18 Years to 100 Years
Inclusion criteria
Inclusion criteria: Current key inclusion criteria as of 30/07/2025: 1. =18 years of age 2. Presenting to the ED 3. Presenting with self-harm, i.e., an intentional act of self-poisoning or self-injury, irrespective of the motivation or apparent purpose of the act and/or presenting with suicidal ideation, i.e., thoughts of not wanting to live on presenting to the ED with self-harm and/or suicidal ideation, can be admitted for a brief admission to the acute hospital or a brief crisis admission 4. Provide informed consent to take part Previous key inclusion criteria as of 07/02/2024 to 30/07/2025: 1. 16 years of age or older 2. Presenting to the ED 3. Presenting with self-harm, i.e., an intentional act of self-poisoning or self-injury, irrespective of the motivation or apparent purpose of the act and/or presenting with suicidal ideation, i.e., thoughts of not wanting to live 4. On presenting to the ED, can be admitted for a brief admission to the acute hospital Previous key inclusion criteria: 1. >16 years of age 2. Presenting in the ED 3. Presenting with self-harm, i.e., an intentional act of self-poisoning or self-injury, irrespective of the motivation or apparent purpose of the act 4. On presenting to the ED, can be admitted for a brief admission to the acute hospital
Exclusion criteria
Exclusion criteria: Current participant exclusion criteria as of 30/07/2025: 1. A current or previous participant of the ASSURED study 2. Patients admitted to a psychiatric hospital 3. Patients receiving input from Child and Adolescent Mental Health Services (CAMHS). Patients receiving service input from CAMHS will be excluded from the date of implementation of Substantial Amendment 5. 4. Patients with cognitive (e.g. dementia) or other psychiatric difficulties interfering with the ability to participate 5. Experiencing a psychotic episode 6. No capacity to provide written informed consent 7. Needing an interpreter 8. Ministry of Justice patients subject to a restriction order 9. Patients receiving intensive psychological input that explicitly precludes them from engaging in other psychological interventions/psychological treatment, e.g. DBT 10. Concerns about safety to practitioner or researcher * 11. Not being registered with a GP 12. Living out of Trust** * Given that the intervention and the researcher meetings are conducted remotely most of the time, please liaise with the local PI about excluding patients for safety-related concerns. **Neighbouring Trusts may be included if agreed with the local PI and documented in the TMF. Planning to move out of the Trust area within ~2 months of enrolling in the study is a reason for exclusion. Previous participant exclusion criteria as of 07/02/2024 to 30/07/2025: 1. Patients admitted to a psychiatric hospital 2. Patients with cognitive (e.g. dementia) or other psychiatric difficulties interfering with ability to participate 3. Experiencing a psychotic episode 4. No capacity to provide written informed consent 5. Needing an interpreter 6. Ministry of Justice patients subject to a restriction order 7. Receiving intensive psychological input e.g. DBT 8. Out of the hospital borough and Trust 9. Concerns about safety to practitioner or researcher 10. Not registered with a GP Previous participant exclusion criteria: 1. Patients admitted to a psychiatric hospital 2. Patients with cognitive (e.g. dementia) or other psychiatric difficulties interfering with ability to participate 3. Experiencing a psychotic episode 4. No capacity to provide written informed consent 5. Needing an interpreter 6. Ministry of Justice patients subject to a restriction order 7. Receiving intensive psychological input e.g. DBT 8. Out of the hospital borough and Trust
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Repeat self-harm identified by searching Emergency Department electronic records at the end of the study | — |
Secondary
| Measure | Time frame |
|---|---|
| Current secondary outcome measures as of 07/02/2024: 1. Self-reported self-harm using online surveys at 1, 2, 3, 9, and 18 months 2. Suicidal ideation measured with the Beck Scale for Suicide Ideation (Beck & Steer, 1993) at baseline, 3, 9 and 18 months 3. Psychological wellbeing measured with CORE-OM (Barkham et al., 2001; Mavranezouli et al., 2011) at baseline, 3, 9 and 18 months 4. Social outcomes measured with the Social Outcomes Index (SIX) (Priebe et al., 2008) at baseline, 3, 9 and 18 months 5. Quality of life measured with the EQ-5D-5L (Herdman et al. 2011) at baseline and 3-, 9-, and 18-months. 6. Psychological wellbeing measured using the Warwick-Edinburgh Mental Wellbeing Scales (WEMWBS, short version) (Tennant et al., 2007) at baseline, 3, 9 and 18 months 7. Experiences of care in Accidents & Emergency Questionnaire, devised for this study, and measured at baseline 8. All cause mortality (including suicide) derived from NHS/local authority/coroner records at 18 months 9. All patient attendances to the Emergency Department at 18 months following the index episode extracted from Trust records 10. Total healthcare use measured using the Client Service Resource Inventory at baseline, 3-, 9, and 18-months and NHS Digital data Previous secondary outcome measures as of 01/02/2022 to 07/02/2024: 1. Self-reported self-harm using online surveys at 1, 2, 3, and 18 months 2. Suicidal ideation measured with Beck's Scale for Suicide Ideation (Beck & Steer, 1993) at baseline, 3, 9 and 18 months 3. Psychological wellbeing measured with CORE-OM (Barkham et al., 2001; Mavranezouli et al., 2011) at baseline, 3, 9 and 18 months 4. Social outcomes measured with the Social Outcomes Index (SIX) (S. Priebe et al., 2008) post-baseline and at 3, 9 and 18 months 5. Quality of life measured with the Warwick-Edinburgh Mental Wellbeing Scales (short version) post-baseline and at 3, 9 and 18 months 6. Experiences of attending the Emergency Department Questionnaire, devised for this s | — |
Countries
England, United Kingdom
Contacts
Public ContactAlexandra E. Bakou
Outcome results
None listed