Self-harm
Conditions
Keywords
Deliberate self-harm, Suicide
Brief summary
The aim of this project is to evaluate a novel treatment program for individuals with intractable and lethal self-harm. The main questions are: 1: Is there, in individuals with intractable self-harm, a relevant improvement in daily functioning and is this improvement related to the provided interventions? The secondary research questions are: 2\. Is there, in individuals with intractable self-harm, a relevant improvement in frequency and severity of self-harm? 3\. Is there, in individuals with intractable self-harm, a relevant improvement in voluntary hospital admissions? 4\. Is there, in individuals with intractable self-harm, a relevant improvement in compulsary hospital admissions? 5\. Is there, in individuals with intractable self-harm, a relevant improvement in the use of medication pro re nata? 6\. Is there, in individuals with intractable self-harm, a relevant improvement in cost-effectiveness related to the provided interventions?
Detailed description
Individuals with intractable, imminent and lethal self-harm often have multifaceted psychiatric symptoms, pervasive suffering, high mortality and a reduced level of daily functioning. Severe self-harm can lead to long periods of psychiatric inpatient care which can lead to reduced autonomy and aggravated self-harm. Effects of this care remain uncertain. The Swedish National Board of Welfare has provided National specialized medical care units for severe self-harm behaviour to three Swedish hospitals. In one of this hospitals, Region Skåne, the intervention will be consultation-based. Individuals with intractable self-harm will be offered an assessment and review of all medical records which will result in a individualized intervention plan. Interventions include further assessments and supporting the existing treatment providers, families or caregivers. Recurring network-meetings will occur every three months as well as at he end of the intervention. Data collection will include self-report measures as well as information from charts and national och regional registries.
Interventions
BEHAVIORALNational specialized medical care unit for severe self-harm behaviour-Consultation model
Extensive assessments. Consultation and training for existing treatment providers and caregivers. Network-meetings for providers and caregivers.
Sponsors
Region Skane
Department of Psychology. Lund University.
Department of Clinical Sciences, Malmö. Faculty of Medicine, Lund University.
Study design
Observational model
CASE_ONLY
Time perspective
OTHER
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Having tried or made serious attempt to try at least two different interventions with evidence to reduce self-harm, without sufficient reduction in suffering or self-harm
Exclusion criteria
* Need for translation services to complete measures or interviews * Not able to complete measures or interviews
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The World Health Organization Disability Assessment Schedule II (WHODAS 2.0) | Monthly from baseline to endpointat 24 months and at follow-up at 36 months. | Level of daily functioning and disability in the domains of cognition, mobility, self-care, getting along with other people and life activities. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Five Self-harm behaviour groupings measure (5S-HM) | Weekly from baseline to endpointat 24 months and at follow-up at 36 months. | Indirect and direct self-harming behaviour |
| The 5-level EQ-5D | Monthly from baseline to endpointat 24 months and at follow-up at 36 months. | Quality of life scale |
| Cost effectiveness | Monthly from baseline to endpointat 24 months and at follow-up at 36 months. | Quantities and costs related to healthcare, municipal, social and rescue services. |
Countries
Sweden
Contacts
CONTACTMagnus Nilsson, PhD
CONTACTSofie Westling, MD/PhD
Outcome results
None listed