Self-harm in a time of isolation: What is the evidence to support mobile and internet-based psychological interventions for self-harm?

"Summary

In this blog we summarise the findings and implications of a recent systematic review of studies evaluating the effectiveness and acceptability of mobile- and internet-based psychological interventions for self-harm in adolescents and adults. The COVID-19 pandemic means that mental health services need to adapt quickly to the clinical need for remote care at a time when we anticipate an increase in the incidence and severity of depression and anxiety. There are already particular concerns about adolescents, who have had to adjust to major changes in their schooling or employment, their home environment and family dynamics, and in their social interactions at a critical stage of development. Their need for digital mental health interventions has never been greater. However, digital delivery of psychological interventions should not compromise effectiveness, acceptability, or equitable access.

Only six of the 22 papers included in this systematic review focused on young people aged 18 years and under, but given the paucity of studies (and systematic reviews) on this topic we felt it was important to appraise the evidence presented with a view to its application to adolescent mental health service delivery. This review found limited evidence to support the effectiveness of mobile- and internet-based interventions to address suicidal thoughts and behaviour in adolescents (and adults), and no indication that a particular modality (text messages, mobile apps, internet-based modules) was superior to others. One of the two studies using blended (therapist contact and remote therapy) interventions was found to reduce suicidal ideation to a greater degree over time than a waiting-list control although this was trialled in an adult population.

In this blog, we also consider how NHS mental health services might respond in terms of implementing findings from research on mobile- and internet-based psychological interventions for self-harm in adolescents and adults, paying particular attention to equitable access to services."

Posted on 18 August 2020

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