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Intractable Self-harm-What Support is Effective?

Recruiting
Conditions
Self-harm
Interventions
Behavioral: National specialized medical care unit for severe self-harm behaviour-Consultation model
Registration Number
NCT06099561
Lead Sponsor
Region Skane
Brief Summary

The aim of this project is to evaluate a novel treatment program for individuals with intractable and lethal self-harm.

The main questions are:

1: Is there, in individuals with intractable self-harm, a relevant improvement in daily functioning and is this improvement related to the provided interventions?

The secondary research questions are:

2. Is there, in individuals with intractable self-harm, a relevant improvement in frequency and severity of self-harm?

3. Is there, in individuals with intractable self-harm, a relevant improvement in voluntary hospital admissions?

4. Is there, in individuals with intractable self-harm, a relevant improvement in compulsary hospital admissions?

5. Is there, in individuals with intractable self-harm, a relevant improvement in the use of medication pro re nata?

6. Is there, in individuals with intractable self-harm, a relevant improvement in cost-effectiveness related to the provided interventions?

Detailed Description

Individuals with intractable, imminent and lethal self-harm often have multifaceted psychiatric symptoms, pervasive suffering, high mortality and a reduced level of daily functioning. Severe self-harm can lead to long periods of psychiatric inpatient care which can lead to reduced autonomy and aggravated self-harm. Effects of this care remain uncertain. The Swedish National Board of Welfare has provided National specialized medical care units for severe self-harm behaviour to three Swedish hospitals.

In one of this hospitals, Region Skåne, the intervention will be consultation-based. Individuals with intractable self-harm will be offered an assessment and review of all medical records which will result in a individualized intervention plan. Interventions include further assessments and supporting the existing treatment providers, families or caregivers. Recurring network-meetings will occur every three months as well as at he end of the intervention.

Data collection will include self-report measures as well as information from charts and national och regional registries.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
30
Inclusion Criteria
  • Having tried or made serious attempt to try at least two different interventions with evidence to reduce self-harm, without sufficient reduction in suffering or self-harm
Exclusion Criteria
  • Need for translation services to complete measures or interviews
  • Not able to complete measures or interviews

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Study groupNational specialized medical care unit for severe self-harm behaviour-Consultation modelIndividuals with current severe, imminent and lethal self-harm with a history of at least two interventions without sufficient reduction of self-harm or suffering.
Primary Outcome Measures
NameTimeMethod
The World Health Organization Disability Assessment Schedule II (WHODAS 2.0)Monthly from baseline to endpointat 24 months and at follow-up at 36 months.

Level of daily functioning and disability in the domains of cognition, mobility, self-care, getting along with other people and life activities.

Secondary Outcome Measures
NameTimeMethod
Cost effectivenessMonthly from baseline to endpointat 24 months and at follow-up at 36 months.

Quantities and costs related to healthcare, municipal, social and rescue services.

Five Self-harm behaviour groupings measure (5S-HM)Weekly from baseline to endpointat 24 months and at follow-up at 36 months.

Indirect and direct self-harming behaviour

The 5-level EQ-5DMonthly from baseline to endpointat 24 months and at follow-up at 36 months.

Quality of life scale

Trial Locations

Locations (1)

National Highly Specialized Unit for Self-Harm Behaviours, Skåne

🇸🇪

Lund, Skåne, Sweden

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