TY - JOUR
PY - 2019//
TI - Feasibility and acceptability of suicide prevention therapy on acute psychiatric wards: randomised controlled trial
JO - BJPsych open
A1 - Haddock, Gillian
A1 - Pratt, Daniel
A1 - Gooding, Patricia A.
A1 - Peters, Sarah
A1 - Emsley, Richard
A1 - Evans, Emma
A1 - Kelly, James
A1 - Huggett, Charlotte
A1 - Munro, Ailsa
A1 - Harris, Kamelia
A1 - Davies, Linda
A1 - Awenat, Yvonne
SP - e14
EP - e14
VL - 5
IS - 1
N2 - BACKGROUND: Suicidal behaviour is common in acute psychiatric wards resulting in distress, and burden for patients, carers and society. Although psychological therapies for suicidal behaviour are effective in out-patient settings, there is little research on their effectiveness for in-patients who are suicidal.AimsOur primary objective was to determine whether cognitive-behavioural suicide prevention therapy (CBSP) was feasible and acceptable, compared with treatment as usual (TAU) for in-patients who are suicidal. Secondary aims were to assess the impact of CBSP on suicidal thinking, behaviours, functioning, quality of life, service use, cost-effectiveness and psychological factors associated with suicide.
METHOD: A single-blind pilot randomised controlled trial comparing TAU to TAU plus CBSP in in-patients in acute psychiatric wards who are suicidal (the Inpatient Suicide Intervention and Therapy Evaluation (INSITE) trial, trial registration: ISRCTN17890126). The intervention consisted of TAU plus up to 20 CBSP sessions, over 6 months continuing in the community following discharge. Participants were assessed at baseline and at 6 weeks and 6 months post-baseline.
RESULTS: A total of 51 individuals were randomised (27 to TAU, 24 to TAU plus CBSP) of whom 37 were followed up at 6 months (19 in TAU, 18 in TAU plus CBSP). Engagement, attendance, safety and user feedback indicated that the addition of CBSP to TAU for in-patients who are acutely suicidal was feasible and acceptable while on in-patient wards and following discharge. Economic analysis suggests the intervention could be cost-effective.
DISCUSSIONPsychological therapy can be delivered safely to patients who are suicidal although modifications are required for this setting.
FINDINGS indicate a larger, definitive trial should be conducted.Declaration of interestThe trial was hosted by Greater Manchester Mental health NHS Trust (formerly, Manchester Mental Health and Social Care NHS Trust). The authors are affiliated to the University of Manchester, Greater Manchester Mental Health Foundation Trust, Lancashire Care NHS Foundation trust and the Manchester Academic Health Sciences Centre. Y.A. is a trustee for a North-West England branch of the charity Mind.
Language: en
LA - en SN - 2056-4724 UR - http://dx.doi.org/10.1192/bjo.2018.85 ID - ref1 ER -