About the Intervention

The intervention involves a narrative interview and safety plan followed by solution-focused follow-up sessions.

The narrative interview involves the person being asked to tell their story leading up to the crisis to the practitioner. They will then create an enhanced safety plan with the practitioner, following a collaborative planning process. Within 72 hours of leaving the Emergency Department, the person will receive a check-in phone call from the practitioner.

They will be offered face-to-face; telephone; and/or online video-conference meetings over a two-month period with the same practitioner to discuss the patient’s main concerns and, using a solution-focused approach, collaboratively formulate solutions to address these concerns. At three, six and nine months, the person will receive personalised letters to remind them of the safety plan and support networks.

ED Meeting

Initial meeting in the ED

Phone call

Meeting in the Emergency Department (ED)

1st follow up

One week follow up

2nd follow up

Four week follow up

3rd follow up

Eight week follow up

Letters

Letters at 3, 6 and 9 months.

We piloted the intervention in four Emergency Departments with people who had presented with self-harm. We sought feedback to learn from the experiences of practitioners and patients, to help us to refine the approach.

"The Assured approach is a very different perspective in liaison psychiatry. It is very hopeful. Using a solution-focused approach helps people in distress to reimagine and come up with their own achievable goals. And because the person has set their own goals, they are invested."

Practitioner

"It made me feel that there was someone there that cared and wasn't making me feel like I was wasting their time. It sort of made you feel... you do matter."

Patient

"The safety plan was helpful as we figured out who I can turn to if I need to and I think that was the most helpful because I could really think about it."

Patient

"It has been really rewarding doing the follow-ups and getting to do therapeutic work with people."

Practitioner

"I learned quite a lot about myself because, at the time I was very, like, negative and pessimistic about myself. And so once [Practitioner] would ask me, like, “what's your biggest achievements?”, “what you will try?”, and “what do you like most about yourself?” I was struggling to find answers, but then she worked with me to try and like break it down… I realised a lot more about myself, which I transferred because I realised that, okay, I'm resilient and I am hardworking. But going forward when like, for example, it is A-levels right now. They’re so hard, I keep telling myself: “You are resilient”, “You made it this far”, and “You are hardworking."

Patient