A copy of the simple Postcard from the EDge sent to self-poisoning patients
Postcards from the EDge, a Newcastle-based research trial in which “postcards” are mailed to patients who have been hospitalised for self-poisoning, halved the rate of general hospital readmissions and reduced psychiatric hospital admissions by a third, over a five-year period.
Lead researcher Professor Greg Carter*, from the Calvary Mater Newcastle, said that in addition to benefitting patients the intervention yielded substantial savings in hospital bed days.
“Our study shows that a low-cost postcard intervention, in addition to usual follow-up care, continued to be effective over five years in reducing repeat episodes of self-poisoning,” Professor Carter said. “We were also able to report psychiatric hospitalisation data for the first time and showed a reduction in psychiatric admissions over five years”.
The cards bear the inscription “It has been a short time since you were here at the Newcastle Mater Hospital and we hope things are going well for you. If you wish to drop us a note we would be happy to hear from you”. They were mailed at regular intervals as an ongoing expression of support.
“We believe the postcards remind patients that we are thinking of them, hoping things are going well and that they can call us if needed,” Professor Carter said. “We haven’t investigated the [psychological] mechanism of action, so we can’t say exactly how the intervention might work.”
The outcomes are published in the respected British Journal of Psychiatry.
Professor Carter said self-poisoning was the most common type of hospital-treated self-harm, and around 20 per cent of self-poisoning patients made another attempt within one to four years.
Researchers recruited 772 participants and around half were randomly allocated to the intervention, receiving eight postcards over 12 months.
Over five years there were 252 readmissions to the general hospital (representing 335 bed days) in the intervention group and 484 readmissions (641 bed days) in the control group. The number of admissions to a psychiatric hospital was 447 (3,443 bed days) for the intervention group and 710 for the control group (6,008 bed days).
“The reduction in admissions and bed days are clinically significant and also represent a decrease in workload for Emergency Department (ED) and psychiatric hospital staff,” Professor Carter said.
* Conjoint Professor Greg Carter is Acting Director of the Department of Consultation-Liaison Psychiatry at Calvary Mater Newcastle. He researches in conjunction with the HMRI Brain and Mental Health program and the University of Newcastle’s Centre for Translational Neuroscience and Mental Health. HMRI is a partnership between the University of Newcastle, Hunter New England Health and the community.