Self-harm in adolescents Mental and Behavioural Disorders
Conditions
Interventions
Current interventions as of 11/07/2025:
Consenting participants are randomly allocated to one of two groups.
Control group: Participants receive treatment as usual based on recommended NICE care whic
and relevant aftercare if there are ongoing safety concerns.
Intervention group: Participants receive up to six sessions in total, which includes an initial session comprising of a therapeutic assess
Sponsors
City St George's, University of London
Eligibility
Sex/Gender
All
Age
12 Years to 18 Years
Inclusion criteria
Inclusion criteria: Current inclusion criteria as of 11/07/2025: Practitioner participants: NHS practitioners working or allied with CAMHS crisis/urgent care/community teams delivering follow-up care to young people after presenting to ED with self-harm (e.g. mental health nurses, social workers, assistant psychologists, clinical associate psychologists). Adolescent participants: 1. 12-18 years old 2. Presenting in crisis to the ED with self-harm or suicidal ideation with recent self-harm (defined as within one month) Previous inclusion criteria as of 25/06/2025: 1. 12-19 years old 2. Presenting in crisis to the ED with self-harm or suicidal ideation with recent self-harm (within one month) Previous inclusion criteria as of 13/06/2023: Children and adolescents aged 12-19 years who present to recruiting emergency departments with self-harm OR suicidal ideation with recent (in the past month) self-harm Previous inclusion criteria: Children and adolescents aged 12-19 years
Exclusion criteria
Exclusion criteria: Current exclusion criteria as of 11/07/2025: Practitioner participants: No exclusion criteria Adolescent participants: 1. Possible Learning Disability, judged by a clinician 2. Need for more intensive treatment than the intervention offers, e.g. inpatient treatment (tier 4) or intensive/outreach care in the community (Tier 3.5) 3. Current psychotic episode 4. Registered with a GP outside of the mental health NHS Trust catchment area 5. Receiving individual one-to-one psychological therapy for more than one hour per week 6. Interpreter required to complete research procedures Previous exclusion criteria as of 25/06/2025: 1. Possible Learning Disability, judged by clinician 2. Need for intensive treatment (i.e. more intensive treatment than the intervention offers e.g. Tier 3.5 or an inpatient psychiatric admission) 3. Current psychotic episode 4. Registered with a GP outside of the mental health NHS trust catchment area 5. Receiving individual one-to-one psychological therapy for more than one hour per week 6. Interpreter required to complete research procedures Previous exclusion criteria as of 13/06/2023: 1. Intellectual disability as judged by a clinician 2. Currently experiencing an episode of psychosis 3. Registered with a GP outside of the mental health Trust catchment area 4. Need for more intensive care (e.g. tier 3.5 or an inpatient admission) Previous exclusion criteria: 1. Intellectual disability (IQ less than 70) 2. Diagnosis of psychosis 3. Registered with a GP outside of the mental health Trust catchment area 4. Need for more intensive care (e.g. tier 3.5 or an inpatient admission)
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Current primary outcome measure as of 11/07/2025: Self-reported episodes of self-harm within the past month, assessed 6 months post-randomisation. This is a count outcome based on summing the number of episodes of self-harm reported from a single item (“How many times in the past month?”) across the three behavioural domains (suicide attempt, self-harmed without intent to end life, self-harm with ambiguous intent) from the modified version of the Short Form of the Self Injurious Thoughts and Behaviour Interview (SITBI, Nock et al., 2007). Previous primary outcome measure: Number of self-harm episodes during the past month measured using a modified version of the Self-Injurious Thoughts and Behaviours Interview Short Form at baseline and 6 months | — |
Secondary
| Measure | Time frame |
|---|---|
| Current secondary outcome measures as of 11/07/2025: 1. Depressive symptoms, measured by the short version of the Moods and Feelings Questionnaire (MFQ) at baseline and 6 months 2. Anxiety symptoms measured by the Generalised Anxiety Disorder Assessment (GAD-7) at baseline and 6 months 3. Repeat ED attendance due to self-harm: identified in ED medical records, measured by count at baseline and 6 months 4. Death by suicide, i.e., cause of death is intentional self-harm or undetermined intent, identified in NHS records, captured at 6 months 5. School attendance, obtained from the Client Service Receipt Inventory (CSRI), obtained at baseline and 6 months 6. General wellbeing measured by the Warwick-Edinburgh Mental Wellbeing 14-item scale at baseline and 6 months 7. Three separate domains of self-harm behaviour assessed by the modified SITBI Short Form: number of reported episodes of self-harm with suicidal intent, self-harm without suicidal intent, and self-harm where intent is ambiguous, in the past month, at baseline and 6 months 8. Three separate domains of self-harm related suicidal ideation assessed by the SITBI Short Form: number of reported episodes of suicidal ideation, suicide plans, and thoughts of non-suicidal self-injury in the past month, measured at baseline and 6 months 9. Dichotomized self-harm (any self-harm in the past month) assessed by the SITBI short form, at baseline and 6 months 10. Number of young person reported self-harm episodes obtained every two weeks for the duration of 6-month follow-up via text message survey where provided 11. Parent/carer self-reported health-related quality of life assessed by the ED-5D-5L at baseline and 6 months 12. Children’s self-reported health-related quality of life data collected using Child Health Utility 9D (or CHU9D) at baseline and 6 months Other variables: 1. Experiences of care in the ED assessed by a version of the Negative Effects Questionnaire, developed for a similar trial in adults, the ASSURED tr | — |
Countries
England, United Kingdom
Contacts
Public ContactMaria Long
Outcome results
None listed