Citation

McAuliffe C, McLeavey BC, Fitzgerald T, Corcoran P, Carroll B, Ryan L, O'Keeffe B, Fitzgerald E, Hickey P, O'Regan M, Mulqueen J, Arensman E. Br. J. Psychiatry 2014; 204: 383-390.

Affiliation

Carmel McAuliffe, BA, HDip, MPhil, MA, PhD, Health Service Executive South/National Suicide Research Foundation, Cork, and Department of Epidemiology & Public Health, University College Cork, Ireland; Breda C. McLeavey, BSc, MA, PhD, Health Service Executive South, Department of Psychiatry, Cork University Hospital, Ireland; Tony Fitzgerald, BSc, MSc, MS, ScD, Department of Epidemiology and Public Health, University College Cork, Ireland; Paul Corcoran, BSc, MSc, PhD, National Suicide Research Foundation, Cork, Ireland; Bernie Carroll, BSc, Louise Ryan, BSc, Health Service Executive West, St Joseph's Hospital, Limerick, Ireland; Brian O'Keeffe, BA, DipClinPsychol, Health Service Executive West, Tevere Day Hospital, Limerick, Ireland; Eva Fitzgerald, BA, HDipPsychol, Portia Hickey, BSc, Mary O'Regan, BA, MPhil, National Suicide Research Foundation, Cork, Ireland; Jillian Mulqueen, BA, Health Service Executive West, St Joseph's Hospital, Limerick, Ireland; Ella Arensman, MSc, PhD, National Suicide Research Foundation, and Department of Epidemiology & Public Health, University College Cork, Ireland.

Copyright

(Copyright © 2014, Royal College of Psychiatry)

DOI

10.1192/bjp.bp.111.101816

PMID

24434070

Abstract

BACKGROUND: Rates of self-harm are high and have recently increased. This trend and the repetitive nature of self-harm pose a significant challenge to mental health services. AIMS: To determine the efficacy of a structured group problem-solving skills training (PST) programme as an intervention approach for self-harm in addition to treatment as usual (TAU) as offered by mental health services. METHOD: A total of 433 participants (aged 18-64 years) were randomly assigned to TAU plus PST or TAU alone. Assessments were carried out at baseline and at 6-week and 6-month follow-up and repeated hospital-treated self-harm was ascertained at 12-month follow-up. RESULTS: The treatment groups did not differ in rates of repeated self-harm at 6-week, 6-month and 12-month follow-up. Both treatment groups showed significant improvements in psychological and social functioning at follow-up. Only one measure (needing and receiving practical help from those closest to them) showed a positive treatment effect at 6-week (P = 0.004) and 6-month (P = 0.01) follow-up. Repetition was not associated with waiting time in the PST group. CONCLUSIONS: This brief intervention for self-harm is no more effective than treatment as usual. Further work is required to establish whether a modified, more intensive programme delivered sooner after the index episode would be effective.

Language: en