Preliminary outcomes after three months of a self-harm intervention on inpatient female acute wards

Deliberate self-harm is a complex behaviour that is costly to the NHS and associated with increased emergency department attendance and premature death. It is most prevalent amongst females attracting a diagnosis of emotionally unstable personality disorder, most represented in inpatient units and corresponding with lengthier stays. Despite recommendations highlighting the need for therapeutic interventions, diagnostic overshadowing has led to a paucity of therapeutic interventions offered to females in inpatient settings, as well as increased utilisation of restrictive interventions, amplifying the risk of re-traumatisation. Studies have explored the efficacy of interventions tailored to the difficulties experienced by individuals who self-harm, promoting emotional stability and skills acquisition, research specifically on female acute inpatient settings is lacking. This paper discusses the efficacy of an innovative trauma and Dialectal Behavioural Therapy informed brief seven session intervention with supplementary skills groups to reduce self-harming behaviours in females in two acute inpatient units. In addition, 38 group sessions were offered, with an average attendance of three patients per group. Of the 42 patients offered the intervention, 40% completed treatment. There were reliable and significant reductions in clinical symptomology indicative of the effectiveness of the intervention. Positive qualitative feedback for the group intervention revealed themes of interactivity, psychological safety and learning new skills. Overall, incidences of self-harm decreased across both wards. Whilst patient complexities, level of risk and brief admissions may interfere with engagement, it is imperative to continue evaluating outcomes to accurately measure intervention efficacy.