The CO-produced Psychosocial INtervention delivered by GPs to young people after self-harm (COPING): protocol for a feasibility study

Faraz Mughal¹, Carolyn A Chew-Graham¹, Benjamin Saunders¹, Sarah A Lawton¹, Sarah Lewis¹, Jo Smith¹, Gillian Lancaster¹, Ellen Townsend², Christopher J Armitage^{3

4

5}, Peter Bower⁶, Nav Kapur^{5

7

8}, David Kessler⁹, Alba X Realpe^{10

11}, Nicola Wiles¹², Dennis Ougrin¹³, Martyn Lewis¹

Affiliations

¹ School of Medicine, Keele University, Keele, England, UK.
² School of Psychology, University of Nottingham, Nottingham, England, UK.
³ Manchester Centre for Health Psychology, School of Health Sciences, The University of Manchester, Manchester, England, UK.
⁴ Manchester University NHS Foundation Trust, Manchester Academic Health Sciences Centre, The University of Manchester, Manchester, England, UK.
⁵ NIHR Greater Manchester Patient Safety Research Collaboration, The University of Manchester, Manchester, England, UK.
⁶ Centre for Primary Care and Health Services Research, The University of Manchester, Manchester, England, UK.
⁷ Centre for Mental Health and Safety, Manchester Academic Health Sciences Centre, The University of Manchester, Manchester, England, UK.
⁸ Mersey Care NHS Foundation Trust, Liverpool, England, UK.
⁹ Centre for Academic Primary Care, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, England, UK.
¹⁰ Population Health Sciences, University of Bristol, Bristol, England, UK.
¹¹ NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust, University of Bristol, Bristol, England, UK.
¹² Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, England, UK.
¹³ Youth Resilience Unit, Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, WHO Collaborating Centre for Mental Health Services Development, Queen Mary University of London, London, England, UK.

PMID: 39463843
PMCID: PMC11503009
DOI: 10.3310/nihropenres.13576.2

The CO-produced Psychosocial INtervention delivered by GPs to young people after self-harm (COPING): protocol for a feasibility study

Faraz Mughal et al. NIHR Open Res. 2024.

. 2024 Oct 15:4:27.

doi: 10.3310/nihropenres.13576.2. eCollection 2024.

Authors

Affiliations

¹ School of Medicine, Keele University, Keele, England, UK.
² School of Psychology, University of Nottingham, Nottingham, England, UK.
³ Manchester Centre for Health Psychology, School of Health Sciences, The University of Manchester, Manchester, England, UK.
⁴ Manchester University NHS Foundation Trust, Manchester Academic Health Sciences Centre, The University of Manchester, Manchester, England, UK.
⁵ NIHR Greater Manchester Patient Safety Research Collaboration, The University of Manchester, Manchester, England, UK.
⁶ Centre for Primary Care and Health Services Research, The University of Manchester, Manchester, England, UK.
⁷ Centre for Mental Health and Safety, Manchester Academic Health Sciences Centre, The University of Manchester, Manchester, England, UK.
⁸ Mersey Care NHS Foundation Trust, Liverpool, England, UK.
⁹ Centre for Academic Primary Care, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, England, UK.
¹⁰ Population Health Sciences, University of Bristol, Bristol, England, UK.
¹¹ NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust, University of Bristol, Bristol, England, UK.
¹² Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, England, UK.
¹³ Youth Resilience Unit, Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, WHO Collaborating Centre for Mental Health Services Development, Queen Mary University of London, London, England, UK.

PMID: 39463843
PMCID: PMC11503009
DOI: 10.3310/nihropenres.13576.2

Abstract

Background: Self-harm in young people is a growing concern and reducing rates a global priority. Rates of self-harm documented in general practice have been increasing for young people in the UK in the last two decades, especially in 13-16-year-olds. General practitioners (GPs) can intervene early after self-harm but there are no effective treatments presently available. We developed the GP-led COPING intervention, in partnership with young people with lived experience and GPs, to be delivered to young people 16-25 years across two consultations. This study aims to examine the feasibility and acceptability of conducting a fully powered effectiveness trial of the COPING intervention in NHS general practice.

Methods: This will be a mixed-methods external non-randomised before-after single arm feasibility study in NHS general practices in the West Midlands, England. Patients aged 16-25 years who have self-harmed in the last 12 months will be eligible to receive COPING. Feasibility outcomes will be recruitment rates, intervention delivery, retention rates, and completion of follow-up outcome measures. All participants will receive COPING with a target sample of 31 with final follow-up data collection at six months from baseline. Clinical data such as self-harm repetition will be collected. A nested qualitative study and national survey of GPs will explore COPING acceptability, deliverability, implementation, and likelihood of contamination.

Discussion: Brief GP-led interventions for young people after self-harm are needed to address national guideline and policy recommendations. This study of the COPING intervention will assess whether a main trial is feasible.

Registration: ISRCTN (ISRCTN16572400; 28.11.2023).

Keywords: Protocol; feasibility; general practice; general practitioner; mixed methods; self-harm; young people.

Plain language summary

Self-harm, usually by cutting or overdosing on tablets, affects young people, their families and friends, and society. Young people who self-harm are more likely to self-harm again and suffer from anxiety and depression. The leading cause of death in young people is suicide and over half of young people who die by suicide have previously self-harmed. Self-harm results in around £128 million a year of costs to the NHS. The GP is the most frequently contacted health professional in the NHS for young people who have self-harmed. Therefore, the GP consultation provides a crucial opportunity to intervene early to reduce future self-harm. At present there are no interventions that work for GPs to use with young people who have self-harmed. We thus developed with GPs and patients a new GP-led brief treatment focusing on psychological and social factors for young people 16–25 years after self-harm (called COPING) to be delivered over two appointments. We would now like to test the COPING treatment in general practice to understand whether a future large clinical trial of COPING is doable in the NHS. We will recruit study sites from practices around England and train GPs at sites. We will identify potential participants through three recruitment strategies and all participants will receive the COPING treatment. We will collect follow-up data from young people at two, four, and six months from enrolment, and data will include information about mood, self-harm thoughts, and episodes of self-harm. GPs and participants will be invited for an interview to gain their experiences of COPING. An online survey of GPs in England will gauge interest about engagement in a future trial. This study will assess whether COPING can be evaluated in a large clinical trial in NHS general practice. If feasible and acceptable there is the potential for COPING to substantially benefit patients, GPs, and the NHS.

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Conflict of interest statement

Competing interests: FM and NK were members of the 2022 self-harm NICE clinical guideline development committee. No other competing interests were disclosed.

References

1. National Institute for Health and Care Excellence: Self-harm: assessment, management and preventing recurrence.[NG225],2022. Reference Source - PubMed
1. Knipe D, Padmanathan P, Newton-Howes G, et al. : Suicide and self-harm. Lancet. 2022;399(10338):1903–16. 10.1016/S0140-6736(22)00173-8 - DOI - PubMed
1. McManus S, Gunnell D, Cooper C, et al. : Prevalence of non-suicidal self-harm and service contact in England, 2000-14: repeated cross-sectional surveys of the general population. Lancet Psychiatry. 2019;6(7):573–581. 10.1016/S2215-0366(19)30188-9 - DOI - PMC - PubMed
1. NHS Digital: Mental health of children and young people in England, 2017. [PAS]. 2018. Reference Source
1. Tsiachristas A, Geulayov G, Casey D, et al. : Incidence and general hospital costs of self-harm across England: estimates based on the multicentre study of self-harm. Epidemiol Psychiatr Sci. 2020;29: e108. 10.1017/S2045796020000189 - DOI - PMC - PubMed

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The CO-produced Psychosocial INtervention delivered by GPs to young people after self-harm (COPING): protocol for a feasibility study

Affiliations

The CO-produced Psychosocial INtervention delivered by GPs to young people after self-harm (COPING): protocol for a feasibility study

Authors

Affiliations

Abstract

Plain language summary

Conflict of interest statement

References

LinkOut - more resources

Full Text Sources