Supporting Adolescents with Self-Harm (SASH): How to better help teens seeking support from A+E

Trigger Warning: Self-Harm, Suicide

What is this project?

Young people who self-harm deserve to be listened to, feel supported and be treated with compassion when they access emergency services. Unfortunately, this doesn’t always happen.

That’s why researchers from City, University of London and McPin want to help improve support for teens who go to A+E for self-harm and suicide. They are working together on a research project funded by the Kavli Trust: Supporting Adolescents with Self-Harm (SASH). The SASH Study is looking at a new style of assessment for young people who self-harm and seek support from A+E and crisis teams.

This new approach aims to put the young person’s voice at the centre by:

  • Focusing on what the young person’s hopes are for the assessment
  • Helping them to build a preferred future; and
  • Creating a safety plan that focuses on the young person’s resources and strengths using their own words.

The research team will evaluate the clinical and cost-effectiveness of this new approach which is a brief psychological assessment for young people who go to A+E and/or crisis teams. The assessment has been specifically designed for young people who go to A+E and/or crisis teams with self-harm. The proposal for this research study has been developed with young people with relevant lived experience.

Within this research, the team aim to answer the following questions:

  • Does the new style of assessment reduce repeat self-harm in young people who go to A+E and/or crisis teams with self-harm?
  • Does the new style of assessment improve other outcomes, such as: repeat A+E and/or crisis team care attendance for self-harm, social functioning, emotional and behavioural difficulties, and negative experiences of care?
  • How do minority ethnic, same-sex attracted and gender-diverse young people experience this new style of assessment?
  • Is the new style of assessment cost-effective?

Why is this research important?

When a young person is having a mental health crisis and goes to A+E it is a crucial opportunity to intervene and provide them with meaningful support.

According to research, visits to A+E by adolescents for self-harm are related to repeat self-harm and suicide, with adolescents 8 times more likely to die by suicide compared to those not presenting with self-harm. Young people who go to A+E in a mental health crisis face many difficulties at a vulnerable time.

Young people have voiced facing stigma, feeling unheard and not being provided with tailored and personalised support.

It is crucial that assessment approaches are tailored for those that they intend to help. This research offers a new approach to assessment which could ensure that young people feel safe, understood, supported, and treated with compassion when they seek support for self-harm from A+E and crisis teams.

How are McPin and people affected by mental health problems involved? 

The research team need young people’s input throughout, to make sure their work makes a positive difference to young people.

At McPin, we’re responsible for making sure that the voices of young people with relevant lived experience shape the project. To do this, we have formed a Young People’s Advisory Group (YPAG) who will meet during the project and advise on key aspects.

Young people’s involvement in this project will be crucial. The YPAG will use their lived experience to advise on things like:  

  • making sense of the study findings
  • reviewing written study documents and providing feedback on their relevance and accessibility
  • recruitment across study sites and practitioners
  • co-producing creative resources and activities to ensure the findings of the project are heard! (e.g TikTok, videos, Instagram posts, other online content)

What is the current status of the project?

We have recruited 8 young people aged 16-26 with lived experience of mental health problems (self-harm or suicidal thoughts and/or have experience of accessing mental health services – A+E and/or crisis team care) for the project’s Young People’s Advisory Group (YPAG).

We are currently working with the Young People’s Advisory Group (YPAG) that was set up for the SASH study. Together we have been introduced to the research project, its aims and a breakdown of the psychological intervention and what it involves for young people. Young people continue to be involved in shaping this project and the intervention with McPin and the research team from City, University of London.

Where can I find more information?

For more information about the public involvement within this project, you can get in contact with Emma via email: