Mind the Gap: Group facilitation for frequent repeaters of self-harm Derbyshire Healthcare NHS Foundation Trust

Self-harm is one of the top five reasons for acute medical admission in the UK.

Individuals who repeatedly present following self-harm account for a high proportion of all self-harm related attendances. Yet many people who repeatedly self-harm are falling through the gaps of current service provision.

The team at Derbyshire Healthcare NHS Foundation Trust are exploring whether group sessions with individuals who frequently present to the emergency department could provide a supportive structure which is more suitable and focused on proactive care. This trial will subsequently help clinicians to further develop their knowledge and confidence in how best to support their clients.

The project will involve a weekly group meeting for individuals who frequently present to the emergency department at the Royal Derby Hospital with self-harm, but who are not currently open to mental health services.

A clinician will facilitate the sessions using a compassion-focused approach. The aims are to increase service users’ awareness of and ability to regulate their own parasympathetic systems; increase their self-compassion and compassion towards others; reduce feelings of shame and guilt; and possibly reduce self-harm behaviour as a consequence.

Each session will last an hour, with up to six service users attending. The same clinician will facilitate the clinic each week so that the service users get consistency and continuity of care. The intervention will consist of between 10 and 20 sessions.

The project team will review clinical outcomes and service delivery outcomes in order to extract learning that can be widely disseminated and implemented.