title: Postcard intervention for repeat self-harm: randomised controlled trial.
abstract: BACKGROUND
  Self-harm and suicidal behaviour are common reasons for emergency department presentation. Those who present with self-harm have an elevated risk of further suicidal behaviour and death.
  
  
  OBJECTIVE
  To examine whether a postcard intervention reduces self-harm re-presentations in individuals presenting to the emergency department.
  
  
  METHODS
  Randomised controlled trial conducted in Christchurch, New Zealand. The intervention consisted of six postcards mailed during the 12 months following an index emergency department attendance for self-harm. Outcome measures were the proportion of participants re-presenting with self-harm and the number of re-presentations for self-harm in the 12 months following the initial presentation.
  
  
  RESULTS
  After adjustment for prior self-harm, there were no significant differences between the control and intervention groups in the proportion of participants re-presenting with self-harm or in the total number of re-presentations for self-harm.
  
  
  CONCLUSIONS
  The postcard intervention did not reduce further self-harm. Together with previous results this finding suggests that the postcard intervention may be effective only for selected subgroups.
authors.affiliation: Yale University School of Medicine, Department of Emergency Medicine, 464 Congress Avenue, Suite 260, New Haven, CT 06519, USA. Annette.Beautrais@yale.edu
authors.forename: Annette L
authors.initials: AL
authors.lastname: Beautrais
authors.forename: Sheree J
authors.initials: SJ
authors.lastname: Gibb
authors.forename: Alan
authors.initials: A
authors.lastname: Faulkner
authors.forename: David M
authors.initials: DM
authors.lastname: Fergusson
authors.forename: Roger T
authors.initials: RT
authors.lastname: Mulder
mesh_terms: D000293:Adolescent; D000328:Adult; D015709:Correspondence as Topic; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D011177:Postal Service; D055502:Secondary Prevention; D016728:Self-Injurious Behavior / Q000517:prevention & control*; D013406:Suicide, Attempted / Q000517:prevention & control; D055815:Young Adult