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General practice based intervention to prevent repeat episodes of deliberate self harm: cluster randomised controlled
Olive Bennewith1, Nigel Stocks, David Gunnell
1Division of Primary Health Care, University of Bristol, Bristol BS6 6JL.
BMJ (Clinical Research Ed.)
|May 25, 2002
Summary
A general practice intervention did not reduce repeat episodes of deliberate self harm. However, patients with a history of self harm may benefit, warranting further research into managing self harm patients.
Area of Science:
- Public Health
- General Practice
- Mental Health Research
Background:
- Deliberate self harm is a significant public health concern.
- Effective interventions in general practice are needed to reduce repeat episodes of self harm.
Purpose of the Study:
- To evaluate the effectiveness of a general practice-based intervention aimed at reducing repeat episodes of deliberate self harm.
Main Methods:
- A cluster randomised controlled trial involving 98 general practices.
- The intervention included a general practitioner (GP) invitation letter and management guidelines.
- 1932 patients who presented with deliberate self harm were followed for 12 months.
Main Results:
- The intervention did not significantly reduce the incidence of repeat self harm compared to usual care.
- No significant differences were observed in the number of repeat episodes or time to first repeat.
- A potential benefit was observed in patients with a history of self harm, but an adverse effect was noted in first-time episodes.
Conclusions:
- A general practice-based intervention involving patient invitation and GP guidelines did not decrease repeat self harm.
- Findings suggest a potential benefit for those with prior self harm history, but require cautious interpretation due to inconsistency with prior evidence.
- Further research is essential to identify effective strategies for managing patients who deliberately harm themselves.