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NIHR159868: The acceptability, effectiveness and cost-effectiveness of Enhanced Patient Observation in reducing the risk of self-harm and suicide on psychiatric wards.
Suicide prevention is an important national public health priority. In 2019 the National Health Service announced a plan to focus on reducing self-harm and suicide among people staying in psychiatric hospitals. However, there is currently little evidence to show whether what is done to help psychiatric inpatients is effective or worth the money.
In this project we plan to investigate a practice commonly used in psychiatric hospitals: one-to-one nursing (also called Enhanced Patient Observation; EPO). This aims to help patients feel safe and to stop them from hurting themselves. However, some patients can find it threatening or invasive. We also don't know if it actually works. Our research team, including lived experience experts, plan to carry out a set of studies to learn more about its acceptability and effectiveness.
First, we will talk to current inpatients, carers and ward staff about their experiences of EPO and any suggestions they have to make it better.
We will also collect data from all NHS mental health trusts in England on how much they use EPO on wards and what it costs. We will use anonymised electronic patient records in a smaller number of NHS trusts to identify patients nursed under EPO and compare them with those who are not. These analyses will work out whether EPO works in reducing self-harm and suicide. Using cost data, we will also work out whether EPO is worth the money.
Our lived experience experts will then co-lead a series of workshops for patients and clinical staff to discuss our findings, working out how to provide better care and make sure patients feel safe. We will co-design staff training, patient/carer information, and policy guidelines to help staff support inpatients by improving the quality of care.
Special Interest Group
The UCL Special Interest Group (SIG) in Self-Harm and Suicide is an interdisciplinary group of UCL researchers and clinicians from our partner NHS Trusts conducting clinical and public health research on self-harm, suicide attempt and suicide.
If you are a UCL researcher and/or clinicians from our partner NHS Trusts interested in clinical and public health research on self-harm, suicide attempt and suicide, please register your interest in joining the SIG by entering your details at this link, or find out more on our website.
