Self-harm is described as intentional self-poisoning or injury, regardless of the reason behind it (National Institute for Health and Care Excellence, 2022). The prevalence of self-harm has been rising, with 25.7% of women and 9.7% of men reporting instances of self-harm throughout their lives (McManus et al., 2016). Certain populations, such as LGBTQ+ individuals, those from non-white ethnic backgrounds, and those from deprived socio-economic backgrounds, have been found to have different rates of self-harm (Liu et al., 2019; Bhui et al., 2007; Geulayov et al., 2022). Furthermore, self-harm is associated with suicidal behavior (Geulayov et al., 2019), making it a critical and complex phenomenon that requires attention.
Stevens and colleagues (2024) conducted a study to investigate whether a brief text message intervention could help reduce the need for individuals to return to the hospital for self-harm treatment. This randomized controlled trial (RCT) is the first of its kind to explore this intervention on a wider population in Australia, as previous research has mainly focused on specific groups such as military personnel. The study aimed to assess the effectiveness of sending nine brief text messages over 12 months to individuals discharged from hospitals in New South Wales, Australia.
Throughout the study, participants were randomly assigned to either receive treatment as usual (TAU) or TAU plus the SMS intervention. Results showed that individuals receiving TAU plus the SMS intervention had a 22% reduction in the number of re-presentations for self-harm treatment at 12 and 24 months following the intervention. This reduction was more pronounced in females compared to males, and there was no significant difference in the time between repeat self-harm presentations for both groups over the 24-month period.
While the study showed promising results in reducing hospital re-presentations for self-harm, further research is needed to validate the efficacy and affordability of the SMS intervention. The study had strengths such as being the first to explore such an intervention in a broader population and using personalized messages created by individuals with lived mental health experience. However, limitations included the use of a non-standardized TAU condition and the single-consent Zelen design, which may have influenced participant behavior and caused attrition bias.
Overall, the study suggests that a brief text message intervention could help reduce repeat self-harm re-presentations to the hospital, providing a potentially easy-to-implement tool for practitioners. Further research is needed to understand the mechanisms behind this reduction and ensure the intervention’s effectiveness in reducing self-harm incidents. The implications of such interventions are significant for patients, services, and practitioners, as they may help alleviate the burden of self-harm on the healthcare system and improve patient outcomes.
