The development and feasibility evaluation of a low-intensity intervention for reducing self-harm and suicidal behaviour

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Suicide is a global problem. In the UK, more than 5000 individuals end their own life every year. Despite this, there are few effective interventions proven to significantly reduce the frequency or severity of suicidal thoughts and attempts. With the burden on mental health services being at an all-time high, especially following the Covid-19 pandemic, there is a need for low intensity, accessible interventions.The proposed project aims to address this gap by developing a self-driven, low-intensity, positively-focused intervention which targets known mechanisms underlying suicidal behaviour. Theories of suicide posit that psychological pain, caused by thwarted needs and hopelessness, can lead to suicidal ideation and that a combination of reduced connectedness to others or a meaningful life can lead to a suicide attempt. Exposing individuals to positive, inspiring messages has been shown to reduce suicidal outcomes. This project will offer a new intervention that targets hopefulness and engagement in meaningful behaviour with the aim of increasing wellbeing and reducing suicidal thoughts and behaviour.Through a mixed method design, the new intervention will develop through an in-depth knowledge of the prior literature and working alongside experts-by-experience. The first stage of the project will involve conducting a literature review of positive interventions targeting the mechanisms of interest. Subsequently, a new intervention will be co-designed in accord with an established framework for co-production (e.g. EBCD by Point of Care Foundation). This approach will comprise of initial co-design events, ongoing workshops with a smaller group of PPI contributors and a final review event. Finally, a pilot study looking at the acceptability and feasibility of the new intervention will be conducted with NHS service users who have been waitlisted for more intense therapeutic support. This final stage will assess pre- and post-intervention clinical outcomes, as well as determine feasibility through an analysis of recruitment, retention, and adherence data. Nested within the pilot study will be a process evaluation, informed by implementation science, of the acceptability of the new intervention from the participants' perspectives.This research will contribute to current knowledge around effective interventions for self-harm behaviour. Such an intervention will be of use to those awaiting more intense psychological therapy, either by helping them manage their symptoms and distress to a level that will make more intense therapy more effective or even to address their need for further support, potentially alleviating the burden on services and freeing up resources.