@article{ref1,
title="The ACCESS study: Zelen randomised controlled trial of a package of care for people presenting to hospital after self-harm",
journal="British journal of psychiatry",
year="2015",
author="Hatcher, Simon and Sharon, Cynthia and House, Allan and Collins, Nicola and Collings, Sunny and Pillai, Avinesh",
volume="206",
number="3",
pages="229-236",
abstract="Background The problem of people presenting to hospitals with self-harm is important because such presentations are common, there is a clear link to suicide and a high premature mortality. However, the best treatment for this population is unclear. Aims To see whether a package of measures, that included regular postcards and problem-solving therapy, improved outcomes at 1 year compared with usual care in people who presented to hospital with self-harm (the ACCESS study: trial registration Australian and New Zealand Clinical Trials Registry ACTRN12609000641291). <br><br>METHOD The design of the study was a Zelen randomised controlled trial. The primary outcome was re-presentation to hospital with self-harm within 12 months of the index episode. <br><br>RESULTS There were no significant differences in the primary outcome and most of the secondary outcomes between the two groups. About half the people offered problem-solving therapy did not receive it, for various reasons. <br><br>CONCLUSIONS The package as offered had little effect on the proportion of people re-presenting to hospital with self-harm. The dose of problem-solving therapy may have been too small to have an effect and there was a difficulty engaging participants in active treatment.<p /> <p>Language: en</p>",
language="en",
issn="0007-1250",
doi="10.1192/bjp.bp.113.135780",
url="http://dx.doi.org/10.1192/bjp.bp.113.135780"
}