Clinical effectiveness and safety of adding a self-harm prevention app (BlueIce) to specialist mental health care for adolescents who repeatedly self-harm: A single blind randomised controlled trial (the BASH study)

Paul Stallard, Kathryn Whittle, Emma Moore, Antonieta Medina-Lara, Nia Morrish, Bethany Cliffe, Shelley Rhodes, Gordon Taylor

Research output: Contribution to journalArticlepeer-review


No randomised controlled trials have evaluated whether the addition of a smartphone app to usual child and adolescent mental health care (CAMHS) can reduce self-harm in adolescents (<18 years) with repeated self-harm. We enrolled 170 participants aged 12–17, receiving CAMHS treatment who had self-harmed ≥2 in the past 12 months. Participants were randomised via an independent web-based system (1:1, minimised for gender, age, self-harm frequency, and depression severity) to treatment as usual (TAU) or treatment as usual plus BlueIce (TAU+BI). BlueIce is a self-harm prevention app that includes techniques from CBT and DBT that was co-designed with adolescents who self-harm. The primary outcome was change from baseline to 12-weeks on the self-harm scale of the Risk Taking and Self-Harm Inventory for Adolescents (RTSHIA), analysed by intention to treat (ITT). Emergency department attendances or admissions for self-harm were assessed over 6-months via a review of clinical records. Both groups improved but there were no statistically significant between group differences at 12 weeks or 6 months on the self-harm scale of the RTSHIA. There were fewer emergency department attendances and admissions in those who received the app, a finding that approached statistical significance. BlueIce can be helpful in some important aspects by contributing to fewer emergency department admissions and attendances. Trial registration: Trial registration number ISRCTN10541045.

Original languageEnglish
Article number116017
JournalPsychiatry Research
Early online date10 Jun 2024
Publication statusE-pub ahead of print - 10 Jun 2024


  • Adolescent
  • BlueIce
  • Mental health
  • Self-harm
  • Smartphone app

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry

Cite this