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Health Series: Research Spotlight

Five year project will investigate how to support and protect those who self-harm

A new £2.7m research project will investigate how to better prepare NHS accident and emergency departments to engage and safeguard patients who self-harm

by Shamim Quadir (Senior Communications Officer)

Professor Rose McCabe leads the Centre for Mental Health Research at City, University of London. Working with colleagues across a number of universities, she will be leading a new £2.7 million research project that will investigate how to better prepare NHS accident and emergency departments to support and protect patients who self-harm, with the aim of reducing further episodes of self-harm and the risk of suicide.

The project is funded by a National Institute for Health Research (NIHR) Programme Grant for Applied Research (PGfAR).

Starting in May 2019, the researchers will conduct focus groups with mental health practitioners (MHPs) and service users, provide training to develop the skills of MHPs, and conduct a national study, across 22 accident and emergency departments.

Self-harm is the most important risk factor for suicide in the UK, and is the single biggest cause of death of people aged 20-24 in the UK.

Accident and emergency departments in England manage about 220,000 self-harm patient contacts every year, and between one to three per cent of people who attend, and who harm themselves, take their own life the following year. Self-harm patient contacts in England increase significantly from the age of 12 years and decline from the mid-20s onwards.

Self-harm leads to high levels of personal suffering, poor mental health, poor quality of life, and high informal and formal support needs from family, friends and mental health practitioners. For younger people, this is exacerbated by poorer educational outcomes setting them on a negative life trajectory. One strand of the new research project will focus specifically on the needs of young people who self-harm.

Currently, when someone who has harmed themselves is seen in an accident and emergency department, a mental health practitioner (MHP) will usually assess their psychological state, social situation and needs for support.

Despite there being many examples of good care, the approach is not evidence based.

Commenting on the rationale for the new project, Professor McCabe said:

Successful studies in other countries have used an approach which trains mental health practitioners in brief psychological techniques, including exploration and validation of the patient’s distress, goal setting, problem solving and goal implementation techniques. These help the mental health practitioner work with the patient to create a personal plan for future crises, and to make contact with the patient after they leave the accident and emergency department, which reduces subsequent self-harm and deaths by suicide. Our new project will test whether this approach can help people seen within the NHS.

The research team will work closely with the Service User and Carer Group Advising on Research (SUGAR) at City, people with lived experience of self-harm, carers and clinicians throughout this new research programme.

Findings from the project will be shared widely, including with members of the Zero Suicide Collaborative, and the question of whether the approach could be helpful in other settings will be explored.

Professor Debra Salmon, Dean of the School of Health Sciences at City, said:

“The interaction between the person with self-harm and the mental health practitioners who support them is critical to engaging them in treatment and helping them cope.

“If found effective, this new approach will improve the mental health of people who harm themselves in England, reduce their need for healthcare services and accident and emergency department attendance, and most importantly, save lives.”

Getting support

If you're a student at City, and need support, you can get help through the Student Counselling and Mental Health Service.

If you're a member of staff at City, you can access support through the Occupational Health Service.

If you, or someone you know, needs support there are number of helplines you can call:

Samaritans – for everyone

Call 116 123 - 24 hours a day, every day

Email jo@samaritans.org

Campaign Against Living Miserably (CALM) – for men

Call 0800 58 58 58 – 5pm to midnight every day

Visit the webchat page – 5pm to midnight every day

Papyrus – for people under 35

Call 0800 068 41 41 – Monday to Friday 10am to 10pm, weekends 2pm to 10pm, bank holidays 2pm to 5pm

Text 07786 209697

Email pat@papyrus-uk.org

Childline – for children and young people under 19

Call 0800 1111 – the number won't show up on your phone bill

The Silver Line – for older people

Call 0800 4 70 80 90 – 24 hours a day, every day

Anyone can also contact their GP for advice and support.

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