Intensive community treatment sees reduction of self-harm in young psychiatric patients

Providing young psychiatric patients with community treatment makes them less likely to self-harm, a study has suggested.

Intensive community care for adolescents with severe mental health disorders not only brought down the usage of inpatient beds, but reduced the likelihood of multiple episodes of self-harm by 82%.

Researchers from South London and Maudsley NHS Foundation Trust said it also helped youngsters return to school.

They said urgent psychiatric admission can lead to serious distress in adolescents and the highest risk of suicide and self-harm takes place following discharge from an inpatient setting.

The study, published in the Lancet Psychiatry journal, involved 106 patients aged between 12 and 18 who were admitted to inpatient units at the trust, or private inpatient units when units at the trust were full.

They were randomly allocated to receive either the usual inpatient care followed by a return to standard outpatient care, or to be discharged early with intensive community support.

This saw them offered intensive therapeutic support and access to home treatment, including mental state monitoring, the administering of medication, the monitoring of side effects and individualised psychotherapies.

The total cost of all health and social care services used by participants over the six-month follow-up period were, on average £3,675 lower for young people receiving intensive community treatment than for young people receiving usual care.

Lead author Dr Dennis Ougrin, consultant child and adolescent psychiatrist at the trust, and clinical senior lecturer in child and adolescent psychiatry at King’s College London, said: “In the first UK trial of its kind, intensive community care provided to adolescents with severe mental health disorders reduced inpatient bed usage but had no effect on functional status and symptoms of most mental health disorders compared with usual care.

“Adolescents who received intensive community care had reduced self-harm and improved reintegration into school.”

Emeritus Professor Eric Taylor, from King’s College London’s Institute for Psychiatry, Psychology & Neuroscience (IoPPN), and honorary consultant at the trust, said: “The implication is that this method of treatment is an affordable and safe way of helping children with severe illnesses to live in their natural communities for longer.”

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