Evidence-based practice for young people who self harm: can it be sustained and does it improve outcomes?

Einfeld, Stewart; Beard, John D.; Tobin, Margaret; Buss, Richard; Dudley, Michael; Clarke, Adam R.; Knowles, Michelle; Hamilton, Blake

doi:10.1071/ah020178

Cited by 3 publications

(4 citation statements)

References 15 publications

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“…Previous findings (Einfeld et al 2002) indicated that the services involved in YARDS showed significant improvements in the management of young people with DSH behaviour, and that these service enhancements were maintained 9 months following the conclusion of the project. The results of the present study showed that the improvements made during the YARDS project were maintained during the 4 years following the project.…”

Section: Discussionmentioning

confidence: 90%

“…The YARDS project was aimed at enhancing the clinical management of young people presenting after an episode of Deliberate Self-Harm (DSH) (that is, suicidal behaviour). The project, and its short-term follow-up have been described previously in two papers in Australian Health Review (Tobin, et al 2001;Einfeld et al 2002). In summary, staff from the project team worked closely with mental health service providers and emergency departments to develop and implement changes designed to enhance the service performance and clinical care for young people with DSH.…”

Section: Discussionmentioning

confidence: 99%

“…SAS scores at the conclusion of the project were compared with SAS scores obtained from a 9-month follow-up (Einfeld et al 2002). No significant difference was found between SAS scores at the end of the YARDS project and SAS scores at the nine-month follow-up, indicating that, in the short-term at least, service enhancements developed during the YARDS project were sustained.…”

Section: Discussionmentioning

confidence: 99%

“…The Service Activity Scale (SAS): The Service Activity Scale (SAS) was used to assess the degree to which services were implementing the service enhancements developed during the YARDS project. Details of this measure were published in the earlier reports in Australian Health Review (Tobin et al 2001, andEinfeld et al 2002). In brief, the SAS is divided into four sections assessing best practice in emergency response, specialist referral, ongoing treatment and discharge process.…”

Section: Methodsmentioning

confidence: 99%

See 3 more Smart Citations

Sustaining evidence-based practice for young people who self-harm: a 4-year follow-up

Einfeld

Tobin²,

Beard³

et al. 2004

Aust. Health Review

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Sustaining evidence-based practice for young people who self-harm: a 4-year follow-up

Einfeld

Tobin²,

Beard³

et al. 2004

Aust. Health Review

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Pediatric Suicide-Related Presentations: A Systematic Review of Mental Health Care in the Emergency Department

Newton

Hamm

Bethell

et al. 2010

Annals of Emergency Medicine

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Study Objective-We evaluated the effectiveness of interventions for pediatric patients with suicide-related emergency department (ED) visits.Methods-We searched of MEDLINE, EMBASE, the Cochrane Library, other electronic databases, references, and key journals/conference proceedings. We included experimental or quasi-experimental studies that evaluated psychosocial interventions for pediatric suicide-related ED visits. Inclusion screening, study selection, and methodological quality were assessed by two CIHR Author ManuscriptCIHR Author Manuscript CIHR Author Manuscript independent reviewers. One reviewer extracted the data and a second checked for completeness and accuracy. Consensus was reached by conference; disagreements were adjudicated by a third reviewer. We calculated odds ratios (OR), relative risks (RR), or mean differences (MD) for each study's primary outcome with 95% confidence intervals (CI). Meta-analysis was deferred due to clinical heterogeneity in intervention, patient population, and outcome.Results-We included 7 RCTs and 3 quasi-experimental studies grouping and reviewing them according to intervention delivery: ED-based delivery (n=1), post-discharge delivery (n=6), and ED transition interventions (n=3). An ED-based discharge planning intervention increased the number of attended post-ED treatment sessions (MD=2.6; 95%CI:0.05,5.15). Of the 6 studies of post-discharge delivery interventions, one found increased adherence with service referral in patients who received community nurse home visits compared to simple placement referral at discharge (RR=1.28; 95%CI:1.06,1.56). The 3 ED transition intervention studies reported: (1) reduced risk of subsequent suicide following brief ED intervention and post-discharge contact (RR=0.10; 95%CI:0.03,0.41), (2) reduced suicide-related hospitalizations when ED visits were followed up with interim, psychiatric care (RR=0.41; 95%CI:0.28,0.60), and (3) increased likelihood of treatment completion when psychiatric evaluation in the ED was followed by attendance of outpatient sessions with a parent (OR=2.78; 95%CI:1.20,6.67).Conclusion-Transition interventions appear most promising for reducing suicide-related outcomes and improving post-ED treatment adherence. Use of similar interventions and outcome measures in future studies would enhance the ability to derive strong recommendations from the clinical evidence in this area.

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The relationship between first-level leadership and inner-context and implementation outcomes in behavioral health: a scoping review

et al. 2021

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Background First-level leadership is uniquely positioned to support evidence-based practice (EBP) implementation for behavioral health due to first-level leaders’ access to and relationship with service providers. First-level leaders are individuals who directly supervise and manage frontline employees who do not manage others. However, first-level leadership is underrepresented in existing reviews of the impact of leadership on EBP implementation. This review describes the relationship between first-level leadership and implementation determinants and outcomes. Methods A scoping review was performed to synthesize the literature on the relationship between first-level leadership and inner-context and implementation outcomes. A literature search was conducted in PubMed, Eric, PsycINFO, CINAHL, Scopus, and Web of Science. To be eligible, studies had to examine first-level leadership, be conducted in settings providing behavioral health services, and examine the relationship between first-level leadership and an implementation or inner-context outcome. Data extraction and synthesis were performed to describe study characteristics, leader-outcome relationships, and overlap in leadership frameworks. Results Twenty-one records met our inclusion criteria. Studies primarily relied on observational designs and were often cross-sectional. Studies more often examined general leadership rather than leadership strategically focused on EBP implementation (i.e., strategic implementation leadership). Our findings suggest that several forms of first-level leadership are inconsistently related to a broad set of implementation determinants, with infrequent examination of specific implementation outcomes. The broad set of implementation determinants studied, limited number of replications, and inconsistent findings have resulted in sparse evidence for any specific leadership-outcome relationship. The greatest accumulation of evidence exists for general leadership’s positive relationship with providers’ EBP attitudes, most notably in the form of transformational leadership. This was followed by evidence for strategic implementation leadership facilitating general implementation. Our synthesis revealed moderate conceptual overlap of strategic implementation leadership behaviors described in the theory of implementation leadership and theory of middle managers’ role in implementation. Conclusions Our findings suggest that first-level leadership may play an important role in shaping implementation determinants and outcomes, but consistent empirical support is sparse and confidence dampened by methodological issues. To advance the field, we need studies that adopt stronger methodological rigor, address the conceptual overlap in leadership frameworks, examine a broader set of implementation outcomes, and examine conditions under which leadership impacts implementation. Trial registration This review was not registered.

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Evidence-based practice for young people who self harm: can it be sustained and does it improve outcomes?

Cited by 3 publications

References 15 publications

Sustaining evidence-based practice for young people who self-harm: a 4-year follow-up

Sustaining evidence-based practice for young people who self-harm: a 4-year follow-up

Pediatric Suicide-Related Presentations: A Systematic Review of Mental Health Care in the Emergency Department

The relationship between first-level leadership and inner-context and implementation outcomes in behavioral health: a scoping review

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