Impact Evaluation of a 'Brief Intervention Program' for Clients who Deliberately Self-Harm

Abstract

Deliberate self harm (DSH) and suicide rates are recognised internationally, nationally and locally as an increasing trend. The financial and emotional cost to society highlights the need for providing services that aim to reduce the likelihood of further deliberate self harm. The emergency department (ED) is often the entry point for service provision to clients who deliberate self harm. A reduction in re-presentations for acts of DSH to the ED would greatly reduce the strain on this essential part of the public healthcare system. It is vital that the services developed to address DSH are evaluated to facilitate informed decisions regarding program sustainability or improvement. Study aim: This study aims to evaluate a 'brief intervention program' (BIP) designed to address the needs of clients who presented with or were at risk of engaging in act(s) of deliberate self harm. The intention of the program was to reduce repetitive acts of DSH and to assist the clients in developing better coping strategies. Study design: This study uses a pluralistic evaluation research design to conduct a program evaluation. The 'line of enquiry' is guided by the Impact Evaluation framework by Owen (2006).The seven steps of the framework were used to organise, categorise, analyse and discuss the program's outcomes in this study. The pluralistic or mixed design used pre-existing quantitative client file data and qualitative data collected from a staff questionnaire. A total number of 40 client files were examined for the data analysis. Six out of the ten staff members agreed to participate in a survey that sought information about the program's implementation. Findings: Results from the quantitative data analysis found that 82.1% of clients did not re-present to the ED with a repeated act of DSH for a period of six months following initial referral and treatment. The mean average of days to follow up was 5.54. Outcome measurements via pre and post PANSI scores found an improvement in the client's resiliency. Results from the repeated measures t-test: p< .05. Qualitative data analysis found that by expanding the referral base that stakeholders perceived it was more difficult for clients to be followed up within five days from their referral date. Other suggestions pertained to increasing the resources of the program for sustainability. Contribution: The use of program evaluation strategies compliments current trends in healthcare to employ pluralistic or mixed method designs. Broader lines of enquiry lead to more informed decisions regarding program sustainability or improvement.