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Crisis telephone consultation for deliberate self-harm patients: Effects on repetition

  • Mark O. Evans (a1), H. G. Morgan (a1), Alan Hayward (a2) and David J. Gunnell (a3)

Abstract

Background

No interventions have been shown to be effective in reducing deliberate self-harm (DSH) repetition in this group of patients as a whole.

Aims

To investigate the effect on repetition of offering emergency telephone support in a group of hospital-admitted DSH patients.

Method

Atotal of 827 DSH patients admitted to medical wards were randomly allocated to either control or intervention (green card) groups. In addition to treatment as usual, the intervention group was offered telephone support should any further crises occur. The main outcome measure was DSH repetition within six months of the index event.

Results

The intervention had no significant effect on the overall DSH repetition rate (odds ratio 1.20, 95% CI 0.82–1.75). Sub-group analysis suggested that response to the intervention differed according to the past history of DSH – subjects with a previous history repeating more often and first-timers appearing to benefit.

Conclusions

No overall effect of the intervention was shown. Conclusions concerning sub-groups must be regarded as speculative, but they suggest that further assessment of the value of telephone support in first-timer DSH patients is indicated.

Copyright

Corresponding author

Dr Mark Evans, Specialist Registrar in Psychotherapy, Brunswick House, 299 Glossop Road. Sheffield S10 2HL

Footnotes

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Declaration of interest

There was no conflict of interest. Funding was provided by a grant from the Department of Health.

Footnotes

References

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Allard, R., Marshall, M. & Plante, M. (1992) Intensive follow-up does not decrease the risk of repeat suicide attempts. Suicide and Life-Threatening Behaviour, 22, 303314.
Hawton, K., Fagg, J., Simkin, S., et al (1997) Trends in deliberate self harm in Oxford. 1985–1995. Implications for clinical services and the prevention of suicide, British Journal of Psychiatry, 171, 556560.
Hawton, K., Arensman, E., Townsend, E., et al (1998) Deliberate self harm: systematic review of efficacy of psychosocial and pharmacological treatments in preventing repetition, British Medical Journal, 317, 441447.
Kapur, N., House, A., Creed, F., et al (1998) Management of deliberate self poisoning in adults in four teaching hospitals: descriptive study. British Medical Journal, 316, 831832.
Kreitman, N. & Foster, J. (1991) The construction and selection of predictive scales, with special reference to parasuicide. British Journal of Psychiatry 159, 185192.
Möller, H. J. (1919) Efficacy of different strategies of after-care for patients who have attempted suicide. Journal of the Royal Society of Medicine, 82, 643648.
Morgan, H. G., Jones, E. M. & Owen, J. K. (1993) Secondary prevention of non-fatal deliberate self-harm: the Green Card study. British Journal of Psychiatry, 163, 111112.
van der Sande, R., van Rooijen, L., Buskens, E., et al (1997) Intensive in-patient and community intervention versus routine care after attempted suicide. A randomised controlled intervention study. British Journal of Psychiatry, 171, 3541.

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Crisis telephone consultation for deliberate self-harm patients: Effects on repetition

  • Mark O. Evans (a1), H. G. Morgan (a1), Alan Hayward (a2) and David J. Gunnell (a3)
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