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?
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.
Study Type
OBSERVATIONAL
Enrollment
30
Extensive assessments. Consultation and training for existing treatment providers and caregivers. Network-meetings for providers and caregivers.
National Highly Specialized Unit for Self-Harm Behaviours, Skåne
Lund, Skåne County, Sweden
RECRUITINGThe World Health Organization Disability Assessment Schedule II (WHODAS 2.0)
Level of daily functioning and disability in the domains of cognition, mobility, self-care, getting along with other people and life activities.
Time frame: Monthly from baseline to endpointat 24 months and at follow-up at 36 months.
Five Self-harm behaviour groupings measure (5S-HM)
Indirect and direct self-harming behaviour
Time frame: Weekly from baseline to endpointat 24 months and at follow-up at 36 months.
The 5-level EQ-5D
Quality of life scale
Time frame: Monthly from baseline to endpointat 24 months and at follow-up at 36 months.
Cost effectiveness
Quantities and costs related to healthcare, municipal, social and rescue services.
Time frame: Monthly from baseline to endpointat 24 months and at follow-up at 36 months.
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