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

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: A total 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.

How negative are we to the idea of suicide prevention?

Assessment of attitudes amongst health care professionals to suicide prevention reveals a considerable degree of doubt with regards to its feasibility and appropriateness. The various professional groups may vary considerably in the degree of negative attitudes which they exhibit. Such findings suggest that there is an urgent need to ensure that health care professionals are fully informed about the key facts concerning suicide and preventive strategies. Key elements of clinical practice and service organization with regards to suicide prevention are discussed.