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Journal Article

Citation

Law YW, Lok RHT, Chiang B, Lai CCS, Tsui SHM, Chung PYJ, Leung SC. JMIR Form. Res. 2023; 7: e43526.

Copyright

(Copyright © 2023, JMIR Publications)

DOI

10.2196/43526

PMID

37585260

Abstract

BACKGROUND: For patients with self-harm behaviors, the urge to hurt themselves persists after hospital discharge, leading to costly readmissions and even death. Hence, postdischarge intervention programs that reduce self-harm behavior among patients should be part of a cogent community mental health care policy.

OBJECTIVE: We aimed to determine whether a combination of a self-help mobile app and volunteer support could complement treatment as usual (TAU) to reduce the risk of suicide among these patients.

METHODS: We conducted a pragmatic randomized controlled trial on discharged patients aged between 18 and 45 years with self-harm episodes/suicide attempts, all of whom were recruited from 4 hospital emergency departments in Hong Kong. Participants were randomly assigned to one of three groups: (1) mobile app + TAU ("apps"), (2) mobile app + volunteer support + TAU ("volunteers"), or (3) TAU only as the control group ("TAU"). They were asked to submit a mobile app-based questionnaire during 4 measurement time points at monthly intervals.

RESULTS: A total of 40 participants were recruited. Blending volunteer care with a preprogrammed mobile app was found to be effective in improving service compliance. Drawing upon the interpersonal-psychological theory of suicide, our findings suggested that a reduction in perceived burdensomeness and thwarted belongingness through community-based caring contact are linked to improvement in hopelessness, albeit a transient one, and suicide risk.

CONCLUSIONS: A combination of volunteer care with a self-help mobile app as a strategy for strengthening the continuity of care can be cautiously implemented for discharged patients at risk of self-harm during the transition from the hospital to a community setting. TRIAL REGISTRATION: ClinicalTrials.gov NCT03081078; https://clinicaltrials.gov/study/NCT03081078.


Language: en

Keywords

thwarted belongingness; suicide; youth; community; risk; intervention; self-harm; treatment; suicidal ideation; effectiveness; model; support; care; hospital; mobile app; patient; volunteers

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