Please select the eligibility criteria that correspond to the clinical trial below.
Title: Text Message Intervention to Reduce Repeat Self-harm in Patients Presenting to the Emergency Department
Brief Summary: Between 6% and 30% of people who harm themselves repeat this self-harm within the following 12 months. The investigators know that people who harm themselves are much more likely to commit suicide, but the investigators have no clear evidence about the best way to reduce the likelihood of someone harming themselves again.

Text messaging is now a common form of communication. Previous research has shown us that the investigators can use text messages for different types of health care interventions. Examples of this include reminding patients of medical appointments, delivering test results, to check patient side effects following treatment and to reduce depressive symptoms in patients with depression and alcohol problems. The Samaritans have introduced interactive text messages (where you can have a conversation by text with their service) and have noted an increasing use of this contact with their service.

This research study is taking place to find out if using supportive and interactive text messages can reduce further episodes of self-harm in patients who present to the Emergency Department (ED) with self-harm.

The investigators hypothesize that supportive, informative and interactive text messages delivered to patients discharged from an ED after an episode of self-harm will significantly reduce the frequency and intensity of thoughts of self-harm and self-harming behaviour in patients compared with those receiving only follow-up treatment as usual. A secondary hypothesis is that patients receiving the text messages will report a favourable experience and an overall satisfaction with the system.


Options:
A: Inclusion Criteria:

* Nurses who responded to the questionnaires received a score on compassion fatigue higher than the mean score (20 points)
* Nurses who worked at clinics and had at least six months of experience

Exclusion Criteria:

* Nurses who responded to the questionnaires received a score on compassion fatigue lower than the mean score (20 points)
* head nurses
B: In phase I

Inclusion Criteria:

1. With self-harm experience in the past month
2. Aged 20 years or over

Exclusion Criteria:

1. With severe hallucinations or delusions or medically unfit for interview
2. Limited hands movement (e.g. seriously wounded wrists)

In phase II

Inclusion Criteria:

1. Admitted to the ER following an episode of self-harm
2. Aged 20 years or over

Exclusion Criteria:

1. With severe hallucinations or delusions or medically unfit for interview
2. Limited hands movement (e.g. seriously wounded wrists)
C: Inclusion Criteria:

* Patients admitted in the period of January 2013 until January 2014
* patients who fulfill the Diagnostic and Statistical Manual-IV Text Revision criteria for BPD,
* patients who have shown suicidal and/or self-harming behavior in the year preceding the admission/ start of DBT treatment, including the last month preceding baseline measurement,
* patients who show a severe level of borderline symptomatology ( \> 24 on the BPDSI),
* patients who are in sufficient command of the Dutch language

Exclusion Criteria::

* Intelligence Quotient \< 80,
* a chronic psychotic condition,
* bipolar disorder,
* hard drug abuse that requires inpatient detoxification,
* forced treatment framework,
* DBT in the year preceding intake.
D: Inclusion Criteria:

* All patients 18 years and over, presenting to the ED with self-harm.
* All patients should have a mobile phone, be familiar with text messaging technology and be willing to take part in the study.

Exclusion Criteria:

* Patients who do not consent to take part in the study.
* Patients who do not have a mobile phone or are unable to use the mobile text message technology.
* Patients who are admitted as a psychiatric inpatient following the assessment in the ED or those who require admission to a medical ward for longer than 48 hours.
* Patients who would be unavailable for follow-up during the study period.

Answer: D