Development of a Brief Intervention for Emergency Department Attendees Presenting With Self-Harm and Co-Occurring...

Area of Science:

• Psychiatry
• Public Health
• Addiction Medicine

Background:

• Individuals presenting to emergency departments with self-harm and co-occurring substance use disorders face significant barriers to accessing effective care.
• This population often experiences complex needs requiring integrated treatment approaches.
• Timely and appropriate interventions are crucial for improving outcomes and reducing recurrent self-harm and substance misuse.

Purpose of the Study:

• To develop a brief psychosocial intervention tailored for individuals with co-occurring self-harm and substance use problems.
• To establish consensus on the core components of this intervention among key stakeholders.
• To create an intervention suitable for future randomized controlled trial evaluation.

Main Methods:

• A modified Delphi method was employed, involving a 3-round online survey.
• Two expert panels, comprising individuals with lived experience (PWLE) and occupational experience (PWOE), participated.
• Consensus was defined as a pooled agreement rate of 80% or more across both panels, informed by literature reviews and stakeholder discussions.

Main Results:

• Expert consensus was reached on 22 essential components for the intervention.
• The finalized intervention includes weekly follow-up phone calls for up to one month.
• Liaison Psychiatry practitioners will deliver the intervention, addressing self-harm and substance use, and facilitating access to community resources.

Conclusions:

• The study successfully identified and agreed upon the key elements of a brief psychosocial intervention for individuals with co-occurring self-harm and substance use issues.
• The developed intervention is designed for feasibility testing and potential future implementation in clinical settings.
• This work represents a significant step towards providing accessible and effective care for a vulnerable patient group.