title: Investigating the feasibility of an enhanced contact intervention in self-harm and suicidal behaviour: a protocol for a randomised controlled trial delivering a Social support and Wellbeing Intervention following Self Harm (SWISH).
abstract: Self-harm is a strong predictor for suicide. Risks for repeat behaviour are heightened in the aftermath of an index episode. There is no consensus on the most effective type of intervention to reduce repetition. Treatment options for patients who do not require secondary mental health services include no support, discharge to general practitioner or referral to primary care mental health support services. The aim of this study is to assess whether it is feasible to deliver a brief intervention after an episode and whether this can reduce depressive symptoms and increase the sense of well-being for patients who self-harm.
  
  
  
  This is a non-blinded parallel group randomised clinical trial. 120 patients presenting with self-harm and/or suicidal ideation to mental health services over a 12-month period who are not referred to secondary services will be randomised to either intervention plus treatment as usual (TAU), or control (TAU only). Patients are assessed at baseline, 4 and 12 weeks with standardised measures to collect data on depression, well-being and service use. Primary outcome is depression scores and secondary outcomes are well-being scores and use of services. The findings will indicate whether a rapid response brief intervention is feasible and can reduce depression and increase well-being among patients who self-harm and do not require secondary services.
  
  
  
  Ethical approval was granted by the UK National Health Service (NHS) Ethics Committee process (REC 6: 14/WA/0074). The findings of the trial will be disseminated through presentations to the participating Health Board and partners, peer-reviewed journals and national and international conferences.
  
  
  
  ISRCTN76914248; Pre-results.
authors.affiliation: Swansea University, Swansea, UK.
authors.forename: Nilufar
authors.identifier: 0000-0003-4274-801X
authors.initials: N
authors.lastname: Ahmed
authors.affiliation: Swansea University, Swansea, UK.
authors.forename: Ann
authors.initials: A
authors.lastname: John
authors.affiliation: Swansea University, Swansea, UK.
authors.forename: Saiful
authors.initials: S
authors.lastname: Islam
authors.affiliation: Hywel Dda University Health Board, Haverfordwest, UK.
authors.forename: Richard
authors.initials: R
authors.lastname: Jones
authors.affiliation: Swansea University, Swansea, UK.
authors.forename: Pippa
authors.initials: P
authors.lastname: Anderson
authors.affiliation: Hywel Dda University Health Board, Haverfordwest, UK.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Davies
authors.affiliation: Swansea University, Swansea, UK.
authors.forename: Ashra
authors.initials: A
authors.lastname: Khanom
authors.affiliation: Swansea University, Swansea, UK.
authors.forename: Shaun
authors.initials: S
authors.lastname: Harris
authors.affiliation: Bangor University, Bangor, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Huxley
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003863:Depression / Q000628:therapy; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data; D008875:Middle Aged; D012107:Research Design; D055502:Secondary Prevention / Q000379:methods*; D016728:Self-Injurious Behavior / Q000523:psychology* / Q000628:therapy*; D012944:Social Support; D014852:Wales; D055815:Young Adult; D000092864:Suicide Prevention
keywords: depression; intervention; randomised controlled trial; self harm; social support; suicide prevention