Interventions to reduce self-harm on in-patient wards: systematic review
Background Incidents of self-harm are common on psychiatric wards. There are a wide variety of therapeutic, social and environmental interventions that have shown some promise in reducing self-harm in in-patient settings, but there is no consensus on the most appropriate means of reducing and manag...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2021-05-01
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| Series: | BJPsych Open |
| Subjects: | |
| Online Access: | https://www.cambridge.org/core/product/identifier/S2056472421000417/type/journal_article |
| _version_ | 1811156930922545152 |
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| author | Rasanat Fatima Nawaz Gurpreet Reen Natasha Bloodworth Daniel Maughan Charles Vincent |
| author_facet | Rasanat Fatima Nawaz Gurpreet Reen Natasha Bloodworth Daniel Maughan Charles Vincent |
| author_sort | Rasanat Fatima Nawaz |
| collection | DOAJ |
| description |
Background
Incidents of self-harm are common on psychiatric wards. There are a wide variety of therapeutic, social and environmental interventions that have shown some promise in reducing self-harm in in-patient settings, but there is no consensus on the most appropriate means of reducing and managing self-harm during in-patient admissions.
Aims
To review interventions used to reduce self-harm and suicide attempts on adolescent and adult psychiatric in-patient wards.
Method
A systematic literature search was conducted between 14 March 2019 and 25 January 2021 using PsycINFO and Medline (PROSPERO ID: CRD42019129046). A total of 23 papers were identified for full review.
Results
Interventions fell into two categories, therapeutic interventions given to individual patients and organisational interventions aimed at improving patient–staff communication and the overall ward milieu. Dialectical behaviour therapy was the most frequently implemented and effective therapeutic intervention, with seven of eight studies showing some benefit. Three of the six ward-based interventions reduced self-harm. Two studies that used a combined therapeutic and ward-based approach significantly reduced self-harm on the wards. The quality of the studies was highly variable, and some interventions were poorly described. There was no indication of harmful impact of any of the approaches reported in this review.
Conclusions
A number of approaches show some promise in reducing self-harm, but the evidence is not strong enough to recommend any particular approach. Current evidence remains weak overall but provides a foundation for a more robust programme of research aimed at providing a more substantial evidence base for this neglected problem on wards.
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| first_indexed | 2024-04-10T04:59:24Z |
| format | Article |
| id | doaj.art-a709bd3939ea4455bc25ec2834230ccf |
| institution | Directory Open Access Journal |
| issn | 2056-4724 |
| language | English |
| last_indexed | 2024-04-10T04:59:24Z |
| publishDate | 2021-05-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | BJPsych Open |
| spelling | doaj.art-a709bd3939ea4455bc25ec2834230ccf2023-03-09T12:29:06ZengCambridge University PressBJPsych Open2056-47242021-05-01710.1192/bjo.2021.41Interventions to reduce self-harm on in-patient wards: systematic reviewRasanat Fatima Nawaz0https://orcid.org/0000-0002-9600-2136Gurpreet Reen1https://orcid.org/0000-0002-2634-6662Natasha Bloodworth2Daniel Maughan3Charles Vincent4https://orcid.org/0000-0003-0270-0222Department of Experimental Psychology, University of Oxford, UK; Patient Safety Collaborative, Oxford Academic Health Science Network, UK; and Department of Psychiatry, University of Cambridge, UKDepartment of Experimental Psychology, University of Oxford, UK; and Oxford Healthcare Improvement Centre, Oxford Health NHS Foundation Trust, UKDepartment of Experimental Psychology, University of Oxford, UK; and Oxford Healthcare Improvement Centre, Oxford Health NHS Foundation Trust, UKOxford Healthcare Improvement Centre, Oxford Health NHS Foundation Trust, UKDepartment of Experimental Psychology, University of Oxford, UK; and Oxford Healthcare Improvement Centre, Oxford Health NHS Foundation Trust, UK Background Incidents of self-harm are common on psychiatric wards. There are a wide variety of therapeutic, social and environmental interventions that have shown some promise in reducing self-harm in in-patient settings, but there is no consensus on the most appropriate means of reducing and managing self-harm during in-patient admissions. Aims To review interventions used to reduce self-harm and suicide attempts on adolescent and adult psychiatric in-patient wards. Method A systematic literature search was conducted between 14 March 2019 and 25 January 2021 using PsycINFO and Medline (PROSPERO ID: CRD42019129046). A total of 23 papers were identified for full review. Results Interventions fell into two categories, therapeutic interventions given to individual patients and organisational interventions aimed at improving patient–staff communication and the overall ward milieu. Dialectical behaviour therapy was the most frequently implemented and effective therapeutic intervention, with seven of eight studies showing some benefit. Three of the six ward-based interventions reduced self-harm. Two studies that used a combined therapeutic and ward-based approach significantly reduced self-harm on the wards. The quality of the studies was highly variable, and some interventions were poorly described. There was no indication of harmful impact of any of the approaches reported in this review. Conclusions A number of approaches show some promise in reducing self-harm, but the evidence is not strong enough to recommend any particular approach. Current evidence remains weak overall but provides a foundation for a more robust programme of research aimed at providing a more substantial evidence base for this neglected problem on wards. https://www.cambridge.org/core/product/identifier/S2056472421000417/type/journal_articleSelf-harmin-patient treatmentpsychiatric nursingprimary careeducation and training |
| spellingShingle | Rasanat Fatima Nawaz Gurpreet Reen Natasha Bloodworth Daniel Maughan Charles Vincent Interventions to reduce self-harm on in-patient wards: systematic review BJPsych Open Self-harm in-patient treatment psychiatric nursing primary care education and training |
| title | Interventions to reduce self-harm on in-patient wards: systematic review |
| title_full | Interventions to reduce self-harm on in-patient wards: systematic review |
| title_fullStr | Interventions to reduce self-harm on in-patient wards: systematic review |
| title_full_unstemmed | Interventions to reduce self-harm on in-patient wards: systematic review |
| title_short | Interventions to reduce self-harm on in-patient wards: systematic review |
| title_sort | interventions to reduce self harm on in patient wards systematic review |
| topic | Self-harm in-patient treatment psychiatric nursing primary care education and training |
| url | https://www.cambridge.org/core/product/identifier/S2056472421000417/type/journal_article |
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