Speek Health

Problem

Dialectical Behaviour Therapy for Adolescents (DBT-A) is a well-established, evidence-based intervention for young people experiencing self-harm and significant emotional dysregulation. Clinical trials indicate that DBT-A is associated with reductions in self-harm and suicidal behaviours, decreased inpatient utilisation, and improvements in emotional regulation. DBT-A is recommended by National Institute for Health and Care Excellence (2022) for adolescents presenting with self-harming behaviours and difficulties associated with emotion dysregulation. NICE (2022) also emphasises the importance of cross-sector awareness, early psychosocial assessment following self-harm, and careful triaging to determine the appropriate level of support.

However, DBT-A is a complex and resource-intensive intervention to implement within routine CAMHS, requiring specialist multidisciplinary training, sustained clinician time, structured group and individual components, and service-level infrastructure to support delivery and fidelity.

Solution

Speek delivers a clinician-supported digital platform that provides safe, evidence-based psychological support to children and adolescents who self-harm, alongside structured guidance for their parents. It addresses key gaps in current mental health provision: long waiting times, limited specialist input, and the exclusion of parents from meaningful support.

The platform combines psychoeducation, DBT-A interventions and reflective tools grounded in established psychological models, adapted for digital delivery. Parents receive tailored guidance to help them respond safely and confidently to self-harm, reducing crisis escalation and improving the home environment. Young people can engage with age-appropriate content at their own pace, outside of overstretched clinical appointments.

Digital delivery enables early intervention, continuity of support between appointments, and reach beyond traditional service thresholds. By supporting families earlier and more consistently, the platform reduces pressure on specialist services while improving outcomes for children at risk of self-harm.

Impact

Speek provides continuous, multi-tiered support aimed at preventing escalation to higher-intensity services. Parents and carers are offered targeted guidance to support wellbeing and maintain day-to-day functioning, thereby improving engagement, retention, and overall family outcomes, with wider benefits for adult services. By intervening early, Speek has the potential to reduce A&E attendances, alleviate workforce pressures, and improve clinical outcomes across the broader NHS system.

Additionally, Speek’s programmes are designed to be more cost-efficient than higher-intensity NHS services.

In Black Country Healthcare NHS Foundation Trust, Speek:

• Eliminated waiting times: Parents accessed specialist DBT-A support within 24 hours versus 4+ month waits for traditional services
• Reduced crisis presentations: 20% decrease in A&E presentations by families using Speek intervention
• Enhanced clinical confidence: 89% of parents reported confidence supporting their young person at home; 10% felt ongoing CAMHS involvement was no longer required
• Extended service reach: 60% of engagement occurred outside traditional hours, serving previously unreachable populations including 57% neurodiverse young people