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Messages from Manchester: pilot randomised controlled trial following self-harm

  • Navneet Kapur (a1), David Gunnell (a2), Keith Hawton (a3), Sarmad Nadeem (a1), Samer Khalil (a1), Damien Longson (a1), Rita Jordan (a1), Iain Donaldson (a1), Richard Emsley (a4) and Jayne Cooper (a5)...
Summary

Studies of therapeutic contact following self-harm have had mixed results. We carried out a pilot randomised controlled trial comparing an intervention (information leaflet listing sources of help, two telephone calls soon after presentation and a series of letters over 12 months) to usual treatment alone in 66 adults presenting with self-harm to two hospitals. We found that our methodology was feasible, recruitment was challenging and repeat self-harm was more common in those who received the intervention (12-month repetition rate 34.4% v. 12.5%).

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Copyright
Corresponding author
Nav Kapur, University of Manchester, Centre for Suicide Prevention, Centre for Mental Health and Risk, Jean McFarlane Building, Oxford Road, Manchester M13 9PL. Email: nav.kapur@manchester.ac.uk
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Declaration of interest

N.K. chaired the National Institute for Health and Clinical Excellence (NICE) guideline development group and evidence update for the longer-term management of self-harm. N.K., D.G., K.H. are members of the National Suicide Prevention Strategy Advisory Group.

Footnotes
References
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1 Hawton, K, Bergen, H, Casey, D, Simkin, S, Palmer, B, Cooper, J, et al Self-harm in England: a tale of three cities. Soc Psychiatry Psychiatr Epidemiol 2007; 42: 513–21.
2 National Institute for Clinical Excellence. Longer-Term Care and Treatment of Self-Harm. NICE, 2011.
3 Kapur, N, Cooper, J, Bennewith, O, Gunnell, D, Hawton, K. Postcards, green cards and telephone calls: therapeutic contact with individuals following self-harm. Br J Psychiatry 2010; 197: 57.
4 Carter, GL, Clover, K, Whyte, IM, Dawson, AH, D'Este, C. Postcards from the EDge: 24-month outcomes of a randomised controlled trial for hospital-treated self-poisoning. Br J Psychiatry 2007; 191: 548–53.
5 Beautrais, AL, Gibb, SJ, Faulkner, A, Fergusson, DM, Mulder, RT. Postcard intervention for repeat self-harm: randomised controlled trial. Br J Psychiatry 2010; 197: 5560.
6 Hassanian-Moghaddam, H, Sarjami, S, Kolahi, A-A, Carter, GL. Postcards in Persia: randomised controlled trial to reduce suicidal behaviours 12 months after hospital-treated self-poisoning. Br J Psychiatry 2011; 198: 309–16.
7 Cooper, J, Hunter, C, Owen-Smith, A, Gunnell, D, Donovan, J, Hawton, K, et al “Well, it's like someone at the other end cares about you.” A qualitative study exploring the views of users and providers of care of contact-based interventions following self-harm. Gen Hosp Psychiatry 2011; 33: 166–76.
8 Vaiva, G, Vaiva, G, Ducrocq, F, Meyer, P, Mathieu, D, Philippe, A, et al Effect of telephone contact on further suicide attempts in patients discharged from an emergency department: randomised controlled study. BMJ 2006; 332; 1241–5.
9 Owens, C. Interventions for self-harm: are we measuring outcomes in the most appropriate way (letter)? Br J Psychiatry 2010; 197: 502–3.
10 Evans, MO, Morgan, HG, Hayward, A, Gunnell, DJ. Crisis telephone consultation for deliberate self-harm patients: effects on repetition. Br J Psychiatry 1999; 175: 23–7.
11 Hatcher, S, Owens, D. Do get in touch. BMJ 2005; 331: 788–9.
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The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
  • URL: /core/journals/the-british-journal-of-psychiatry
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Messages from Manchester: pilot randomised controlled trial following self-harm

  • Navneet Kapur (a1), David Gunnell (a2), Keith Hawton (a3), Sarmad Nadeem (a1), Samer Khalil (a1), Damien Longson (a1), Rita Jordan (a1), Iain Donaldson (a1), Richard Emsley (a4) and Jayne Cooper (a5)...
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