Table 3 GRADE scoring: certainty of the evidence
Model | Outcomes assessed | Comparison group | Direction of effect found | Grade score |
|---|---|---|---|---|
Hospital admission (no comparator models, all studies reporting changes over time) | Symptomatic improvement over time (range of measures including HoNOS) | No, change over time only | Improvement in symptoms scores | Very low ⊕ ◯◯◯ |
Improvement in adaptive functioning over time | No, change over time only | Improvement in adaptive functioning | Very low ⊕ ◯◯◯ | |
The brief admission model of hospital admission | Service use (days in hospital) | Treatment as usual | No effect of the intervention | Moderate ⊕ ⊕ ⊕ ◯ |
Symptomatic improvement (range of measures) | No, change over time only | Improvement in symptoms scores | Very low ⊕ ◯◯◯ | |
NSSI and suicide attempts | Treatment as usual | No effect of the intervention | ⊕ ⊕ ◯◯ Low | |
Health Related QoL | No, change over time only | Improvement in QoL | Very low ⊕ ◯◯◯ | |
Therapeutic alliance | No, change over time only | Improvement in therapeutic alliance | Very low ⊕ ◯◯◯ | |
Crisis teams | CGI | No, change over time only | Improvement in CGI scores | Very low ⊕ ◯◯◯ |
Acute day units | Symptomatic improvement (range of measures) | Telehealth version of ADU (1 study) Otherwise change over time only | Improvement in symptom scores | Very low ⊕ ◯◯◯ |
Social participation | No, change over time only | Improvement in social participation | Very low ⊕ ◯◯◯ | |
Patient Satisfaction | Telehealth version of ADU | Higher satisfaction with in person versus telehealth ADU | Very low ⊕ ◯◯◯ | |
Psychotherapies or psychosocial interventions: Outpatient based | Hospitalisation | TAU or TAU plus waitlist for psychological treatment | Reduction in % hospitalised, increased time to hospitalisation, reduction in number of admissions and bed days | Moderate ⊕ ⊕ ⊕ ◯ |
Suicide attempt or suicide | TAU | Reduction in number of suicidal relapses and time to relapse | Moderate ⊕ ⊕ ⊕ ◯ | |
Symptomatic improvement | No, change over time only | Improvement in symptoms scores | Very low ⊕ ◯◯◯ | |
Psychotherapies or psychosocial interventions: Based in emergency departments, general hospitals or psychiatric emergency services | Repeat suicide attempt | Historical TAU | Reduction in % of participants attempting suicide | Very low ⊕ ◯◯◯ |
Hospitalisation | Historical TAU | Increased time to readmission and reduced days of hospitalisation | Very low ⊕ ◯◯◯ | |
Symptomatic improvement (range of measures) | No, change over time only | Improvement in symptoms scores | Very low ⊕ ◯◯◯ | |
Psychotherapies or psychosocial interventions: groups delivered in inpatient services | Symptomatic improvement (range of measures) | ‘Living well group’ | No effect of the intervention | ⊕ ⊕ ◯◯ Low |
Self-harm (including both suicide attempt and non-suicidal self-harm (NSSH) | No, change over time only | Reduction in frequency of self harm | Very low ⊕ ◯◯◯ | |
Mother and Baby Units | GAF | No, change over time only | Reduction in score from discharge to 3 months | Very low ⊕ ◯◯◯ |
Joint crisis planning | Symptomatic improvement | Treatment as usual | No effect of the intervention | ⊕ ⊕ ◯◯ Low |
NSSI | No effect of the intervention | ⊕ ⊕ ◯◯ Low | ||
Early Intervention Service | Symptomatic improvement | Treatment as usual (hospital-based services) | Greater improvement in the treatment as usual group | ⊕ ⊕ ◯◯ Low |
Social functioning | Greater improvement in the treatment as usual group | ⊕ ⊕ ◯◯ Low |