Assured is a research project that aims to improve support for people with self-harm and/or suicidal ideation presenting in crisis to the Emergency Department. We define self-harm broadly as intentional self-poisoning or self-injury, irrespective of the motive or the extent of suicidal intent; and we define suicidal ideation as thoughts of not wanting to live. We will work to improve three areas in particular:
Emergency Departments in England manage approximately 220,000 self-harm contacts per year. Evidence from Switzerland, the U.S. and other countries show that brief interventions in Emergency Departments for people presenting during crisis are effective in reducing self-harm and suicide.
Currently there is no evidence-based intervention for the NHS context. The Assured team have adapted approaches from other countries into an intervention for the NHS context. This intervention will be evaluated in Emergency Departments in England.
It has the potential to reduce the risk of suicide and self-harm in the UK and improve the experience of attending the Emergency Department for people in crisis
Firstly, we believe conversations could be more supportive for the person. The conversation should focus on listening to the person’s story and making a human connection to instil hope (rather than on predicting risk)
Secondly, safety planning should be more extensive and lead to a plan “in the person’s words” that aims to keep them safe.
Thirdly, many people need rapid follow-up care and connections to community services that provide real support and continuity.
The study is funded by the National Institute for Health Research (NIHR) Programme Grants for Applied Research programme (Ref: RP-PG-0617-20004)
What are we hoping to achieve?
The Assured study aims to understand how to best support patients who attend the Emergency Department with self-harm and/or suicidal ideation. We have developed an intervention and, if it is effective, it may be rolled out in Emergency Departments across England.
The study aims to support patients who self-harm and/or have suicidal ideation. This means individuals who have attended the Emergency Department for the first time, as well as those who may attend more often. We will provide staff training in therapeutic assessment; safety planning; and follow up support using solutions focused approaches. By providing staff with training in techniques shown to best support these patients, as well as supervision, we hope to support staff to feel better equipped to offer high quality care to people presenting in distress. Finally, we hope to create a more efficient means of supporting patients in crisis and to reduce reattendance to the Emergency Department, which will lead to cost-saving for the NHS.
Unfortunately, due to how the study is designed, we are unable to take self-referrals to take part. If you are currently struggling with self-harm and/or suicidal ideation, please visit our ‘get support’ page: Get support – Assured (assuredstudy.co.uk)
Assured is a six-year project which began in May 2019. It consists of six Work Packages.
We will assess whether the intervention leads to reduced re-attendance to the Emergency Department for self-harm, by comparing re-attendance in those participants who have received the intervention with those who receive treatment as usual. We will also measure other outcomes including: mental wellbeing; quality of life; and satisfaction with the care received
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