Psychosocial interventions for self-harm, suicidal ideation and suicide attempt in children and young people: What? How? Who? and Where?

Abstract

We reviewed the evidence for the effectiveness of indicated individual psychosocial interventions for the treatment of self-harm, suicidal ideation and suicide attempts in children and young people, with a particular emphasis on the emerging use of electronic methods to deliver psychological interventions. In total, 16 randomised controlled trials (RCTs) were identified, none of which included children under the age of 12 years. Cognitive-behavioural therapy is the most commonly implemented approach in RCTs until now, although problem-solving therapy, interpersonal psychotherapy, social support and distal support methods by provision of a green card and regular receipt of postcards have also been investigated. Young people have been recruited into RCTs within schools, outpatient clinics, emergency departments and inpatient facilities. Face-to-face delivery of therapy has dominated the intervention trials thus far; however, the use of the internet, social media and mobile devices to deliver interventions to young people and other family members allows for a more novel approach to suicide prevention in youth going forward.

Understanding the Needs of Young People Who Engage in Self-Harm: A Qualitative Investigation

“…Participants wanted channels and templates to support them in making connections when they needed them most and provided a number of useful suggestions for a digital intervention to support social connectedness through messages to significant others and a moderated chat function. In terms of formal therapeutic interventions for young people at risk of self-harm, inclusion of the family and other supports is often emphasized (Fortune et al, 2008;Cox and Hetrick, 2017;Cottrell et al, 2018), and this study extends this to highlight the need for young people to maintain some autonomy and control in terms of with whom and how they share their distress with others. Relevant to building connection, young people also described "changing the environment" as an important strategy for managing urges to self-harm, and this often involved going outside or going out with friends to engage in activities.…”

Association between Childhood Suicidal Ideation and Geriatric Depression in Japan: A Population-Based Cross-Sectional Study

“…Research shows that people living with mental illness often experience a specific series of changes in their thoughts, feelings and behaviors before a relapse, but more than 90% of individuals with suicidal thoughts do not receive mental health services [38]. Our findings suggest that children who have suicidal ideation need psychosocial interventions [39] to restore specific sets of feelings, emotions and behaviors and reduce the risk of poor mental health in late life.…”

Systematic Review and Quality Appraisal of Practice Guidelines for Self‐Harm in Children and Adolescents

“…We agree with these priorities. Other useful recent reviews on the topic of self‐harm and suicide by experts include Cox & Hetrick (); Hawton, Saunders, & O'Connor (); Turecki & Brent (); and Zalsman et al ().…”