Effectiveness of a 'Green Card' Intervention for Patients Engaging in Deliberate Self-harm

A service enhancement program for deliberate self-harm (DSH) patients in two area mental health services in New South Wales, Australia, examined the effectiveness of emergency cards ('Green Cards') in enhancing patients' return rates, and perceived effectiveness by service personnel. Eighty-four percent of patients receiving a Card attended their appointment, compared with 40% receiving another form of referral. The Card did not ensure treatment continuation. Staff feared it might increase referral rates, reinforce DSH behavior and create more work, but this was unsubstantiated. Though Green Cards may be efficacious, their use in health service enhancement brings challenges for implementation not usually discussed in DSH intervention studies. Working with staff regarding barriers to such strategies is crucial to their adoption and success. This report finds the Green Card effective for patients engaging in DSH.

澳大利亚新南威尔士州两个地区的心理健康服务机构针对蓄意自伤（DSH）患者开展了一项服务强化项目，研究了急诊卡（“绿卡”）在提高患者复诊率方面的有效性以及服务人员所感知到的有效性。收到卡的患者中有84%按时就诊，相比之下，接受其他转诊形式的患者只有40%按时就诊。该卡并不能确保治疗的连续性。工作人员担心它可能会增加转诊率、强化自伤行为并增加工作量，但这些担心并无事实依据。尽管绿卡可能是有效的，但在强化卫生服务中使用绿卡带来了实施方面的挑战，而这些挑战在自伤干预研究中通常未被讨论。就此类策略的障碍与工作人员合作对于这些策略的采用和成功至关重要。本报告发现绿卡对蓄意自伤患者是有效的。