Quality statement 7: Psychological interventions

Quality statement

People receiving continuing support for self‑harm have a discussion with their lead healthcare professional about the potential benefits of psychological interventions specifically structured for people who self‑harm.

Rationale

There is some evidence that psychological therapies specifically structured for people who self‑harm can be effective in reducing repetition of self‑harm. The decision to refer for psychological therapy should be based on a discussion between the service user and healthcare professional about the likely benefits.

Quality measure

Structure: Evidence of local arrangements to provide psychological interventions specifically structured for people who self‑harm.

Process:

a) Proportion of people receiving continuing support for self‑harm who have a record of a discussion with their lead healthcare professional about the potential benefits of psychological interventions specifically structured for people who self‑harm.

Numerator – the number of people in the denominator who have a record of a discussion with their lead healthcare professional about the potential benefits of psychological interventions specifically structured for people who self‑harm.

Denominator – the number of people receiving continuing support for self‑harm.

b) Proportion of people who self‑harm who accept referral for psychological intervention and receive at least 3 sessions of a psychological intervention specifically structured for people who self‑harm.

Numerator – the number of people in the denominator receiving at least 3 sessions of a psychological intervention specifically structured for people who self‑harm.

Denominator – the number of people who self‑harm who accept referral for psychological intervention.

What the quality statement means for each audience

Service providers ensure that systems are in place for healthcare professionals to refer people receiving continuing support for self‑harm for 3 to 12 sessions of a psychological intervention specifically structured for people who self‑harm.

Healthcare professionals ensure that they discuss with people receiving continuing support for self‑harm the potential benefits of psychological interventions specifically structured for people who self‑harm.

Commissioners ensure that they commission services that discuss potential benefits of psychological interventions specifically structured for people who self‑harm with people receiving continuing support for self‑harm and can refer them for 3 to 12 sessions.

People who are having long‑term support after self‑harming discuss the possible benefits of psychological treatments for self‑harm with their healthcare professional.

Source guidance

NICE clinical guideline 133 recommendation 1.4.8 (key priority for implementation).

Data source

Structure: Local data collection.

Process: a) and b) Local data collection.

Definitions

People receiving continuing support for self‑harm

Children or young people (aged 8 years and older) and adults who have carried out an act of self‑poisoning or self‑injury, irrespective of motivation, and who are receiving longer‑term psychological treatment and management. It includes people with both single and recurrent episodes of self‑harm. It does not include people having immediate physical treatment or management for self‑harm in emergency departments.

Lead healthcare professional

The professional with overall responsibility for the care and support of a person who has self‑harmed. This could include, but is not limited to, professionals from primary care and community mental health services.

Psychological interventions

NICE clinical guideline 133 recommendation 1.4.8 states:

Consider offering 3 to 12 sessions of a psychological intervention that is specifically structured for people who self‑harm, with the aim of reducing self‑harm. In addition:

  • the intervention should be tailored to individual need, and could include cognitive‑behavioural, psychodynamic or problem‑solving elements

  • therapists should be trained and supervised in the therapy they are offering to people who self‑harm

  • therapists should also be able to work collaboratively with the person to identify the problems causing distress or leading to self‑harm.