Monitoring Deliberate Self-Harm Presentations to General Hospitals

Crisis ◽  
2006 ◽  
Vol 27 (4) ◽  
pp. 157-163 ◽  
Author(s):  
Keith Hawton ◽  
Liz Bale ◽  
Deborah Casey ◽  
Anna Shepherd ◽  
Sue Simkin ◽  
...  
Keyword(s):  
Data Collection ◽  
Suicide Prevention ◽  
Ethical Issues ◽  
Strong Association ◽  
Case Definition ◽  
Prevention Policy ◽  
General Hospitals ◽  
Deliberate Self Harm ◽  
Policy Initiatives ◽  
Self Harm

Monitoring of deliberate self-harm (DSH) presentations to hospitals (and in other settings) is receiving increased attention in many countries. This is due to greater recognition of the size of the problem and awareness of its relevance to suicide prevention policy initiatives, because of the strong association between DSH and suicide. A system for monitoring all DSH presentations has been in place in the general hospital in Oxford for 30 years. Based on our experience, in this paper we describe procedures for monitoring, including case definition and identification, linkage of persons and episodes in order to investigate repetition of DSH and other outcomes (including deaths), and data protection and ethical issues. We also provide details of how to carry out monitoring, including different models of data collection, and what data to collect. Finally we consider the potential uses of the data for both clinical and research purposes, including evaluation of national suicide prevention initiatives.

scholarly journals Retrospective Identification of Episodes of Deliberate Self-Harm from Emergency Room Registers in General Hospitals: An Example from Shanghai

2013 ◽  
Vol 17 (4) ◽  
pp. 345-359 ◽  
Author(s):  
Yeqing Xu ◽  
Michael R. Phillips ◽  
Liwei Wang ◽  
Qiuhong Chen ◽  
Chunbo Li ◽  
...  
Keyword(s):  
Emergency Room ◽  
General Hospitals ◽  
Deliberate Self Harm ◽  
Self Harm

Near-Fatal Self-Harm Among Canadian Adolescents

2021 ◽  
pp. 070674372110586
Author(s):  
Rachel HB Mitchell ◽  
Cornelius Ani ◽  
Claude Cyr ◽  
James Irvine ◽  
Ari R Joffe ◽  
...  
Keyword(s):  
Mental Health ◽  
Suicide Prevention ◽  
Family Conflict ◽  
Suicide Attempts ◽  
Case Definition ◽  
Surveillance Program ◽  
Female Age ◽  
Prevention Interventions ◽  
Working Age ◽  
Self Harm

Objective To evaluate the clinical features of Canadian adolescents admitted to the intensive care unit (ICU) for medically serious self-harm. Methods 2700 Canadian paediatricians were surveyed monthly over two years (January 2017 to December 2018) through the Canadian Paediatric Surveillance Program to ascertain data from eligible cases. Results Ninety-three cases (73 female; age 15.2 ± 1.5) met the case definition. Four provinces reported the majority of cases: Quebec (n = 27), Ontario (n = 26), Alberta (n = 21), and British Columbia (n = 8). There were 10 deaths, 9 by hanging. Overdose and hanging were the most frequently reported methods of self-harm (74.2% and 19.4%, respectively). Overdose was more common in females (80.8% females vs. 50% males; χ2 = 7.8 (1), p = .005), whereas hanging was more common in males (35% males vs. 15.1% females, χ2 = 3.9 (1), p = .04). More females than males had a past psychiatric diagnosis (79% vs. 58%; χ2 = 4.1 (1), p = .06), a previous suicide attempt (55.9% vs. 29.4%, χ2 = 3.8 (1), p = .05), and prior use of mental health service (69.7% vs. 27.8%, χ2 = 10.4 (1), p = .001). Family conflict was the most commonly identified precipitating factor (43%) of self-harm. Conclusions Among Canadian adolescents admitted to the ICU with medically serious self-harm, females demonstrate a higher rate of suicide attempts and prior mental health care engagement, whereas males are more likely to die by suicide. These findings are consistent with data from other adolescent samples, as well as data from working-age and older adults. Therefore, a sex-specific approach to suicide prevention is warranted as part of a national suicide prevention strategy; family conflict may be a specific target for suicide prevention interventions among adolescents.

Deliberate self-harm in Oxford, 1990–2000: a time of change in patient characteristics

2003 ◽  
Vol 33 (6) ◽  
pp. 987-995 ◽  
Author(s):  
K. HAWTON ◽  
L. HARRISS ◽  
S. HALL ◽  
S. SIMKIN ◽  
E. BALE ◽  
...  
Keyword(s):  
Suicide Prevention ◽  
Attempted Suicide ◽  
Psychiatric Care ◽  
Patient Characteristics ◽  
Future Trends ◽  
Clinical Services ◽  
Hospital Services ◽  
Deliberate Self Harm ◽  
Gender And Age ◽  
Self Harm

Background. Trends in deliberate self-harm (DSH) are important because they have implications for hospital services, may indicate levels of psychopathology in the community and future trends in suicide, and can assist in identification of means of suicide prevention.Method. We have investigated trends in DSH and characteristics of DSH patients between 1990 and 2000 based on data collected through the Oxford Monitoring System for Attempted Suicide.Results. During the 11-year study period 8590 individuals presented following 13858 DSH episodes. The annual numbers of persons and episodes increased overall by 36·3% and 63·1% respectively. Rates (Oxford City) declined, however, in the final 3 years. There were gender- and age-specific changes, with a rise in DSH rates in males aged [ges ]55 years and in females overall and those aged 15–24 years and 35–54 years. Repetition of DSH increased markedly during the study period. Antidepressant overdoses, especially of SSRIs, increased substantially. Paracetamol overdoses declined towards the end of the study period. Alcohol abuse, use of alcohol in association with DSH, and violence increased, especially in females, and the proportion of patients in current psychiatric care and misusing drugs also rose.Conclusions. While overall rates of DSH did not increase markedly between 1990 and 2000, substantial changes in the characteristics of the DSH population and a rise in repetition suggest that the challenges facing clinical services in the management of DSH patients have grown.

Suicide and deliberate self-harm

2012 ◽  
pp. 421-440
Author(s):  
Philip Cowen ◽  
Paul Harrison ◽  
Tom Burns
Keyword(s):  
Risk Management ◽  
Suicide Prevention ◽  
Deliberate Self Harm ◽  
Self Harm ◽  
Suicidal Patients

Chapter 16 covers suicide and deliberate self-harm, and covers assessment of risk, management of suicidal patients, suicide prevention, and deliberate self-harm, and its management.

scholarly journals Assessment of deliberate self-harm in adults

1995 ◽  
Vol 1 (5) ◽  
pp. 124-130 ◽  
Author(s):  
David Owens ◽  
Allan House
Keyword(s):  
At Risk ◽  
United Kingdom ◽  
Suicide Prevention ◽  
Suicide Rate ◽  
Prevention Strategy ◽  
Deliberate Self Harm ◽  
The United Kingdom ◽  
Self Harm

Deliberate self-harm remains a common problem in the United Kingdom, with rates in the order of 250–300 per 100 000 per year (Hawton & Fagg, 1992). Since the suicide rate in the 12 months after hospital attendance for deliberate self-harm is around 1% (Hawton & Fagg, 1988), each year approximately 2–3 per 100 000 of the population die by suicide within a year of attending hospital with a non-fatal episode of deliberate self-harm. This is about a quarter of the overall suicide rate of 11 per 100 000. There is therefore an easily definable group at risk of suicide who should be the focus of a suicide prevention strategy.

scholarly journals Selvmordsforebygging skal sitte i veggene: om bygging av nytt Østfoldsykehus

Suicidologi ◽  
2015 ◽  
Vol 18 (2) ◽  
Author(s):  
Kari Gjelstad ◽  
Kim Larsen
Keyword(s):  
Suicide Prevention ◽  
High Standard ◽  
Human Behaviour ◽  
Psychiatric Ward ◽  
Therapeutic Work ◽  
Deliberate Self Harm ◽  
Acute Psychiatric Wards ◽  
Self Harm

Planlegging av bygging og innredning av psykiatriske akuttavdelinger er en prosess som fordrer et blikk for arkitekturens rolle i å påvirke menneskelig adferd og samspill, og bevissthet om viktigheten av arkitektur og innredning i det selvmordsforebyggende arbeidet. En psykiatrisk avdeling skal ha høy grad av sikkerhet mot mulighet for villet egenskade og selvmord, samtidig som den skal gi gode rammer for terapeutisk arbeid og ivareta pasientenes privatliv og integritet på best mulig måte. Artikkelen beskriver erfaringer fra planleggingen av nytt Østfoldsykehus, og gir eksempler på de prosesser og avveininger som legger grunnlag for utforming av bygg og lokaler, samt for valg av materialer og utstyr i en psykiatrisk avdeling. The planning of the construction and furnishing of acute psychiatric wards demands a keen eye for the role of architecture in influencing human behaviour and interaction, and an awareness of the importance of architecture and fixtures in suicide prevention. A psychiatric ward needs a high standard of security to prevent deliberate self-harm and suicide. At the same time, the ward should provide a good location for therapeutic work, and respect the patients' integrity and need for privacy. The paper describes experiences from the planning of a new hospital in Østfold county, and presents examples from the process of cooperation between builder, architects and psychiatric personnel in the construction and furnishing of the psychiatric ward at a new hospital. The paper focuses on the design of the building and facilities as well as choice of materials, fixtures and furniture.

Thirteen-year follow-up of deliberate self-harm, using linked data

1998 ◽  
Vol 172 (3) ◽  
pp. 239-242 ◽  
Author(s):  
David J. Hall ◽  
Fiona O'Brien ◽  
Cameron Stark ◽  
Antony Pelosi ◽  
Helen Smith
Keyword(s):  
Linked Data ◽  
Attempted Suicide ◽  
Alcohol Misuse ◽  
Median Number ◽  
Contributory Factor ◽  
Data Set ◽  
General Hospitals ◽  
Deliberate Self Harm ◽  
Self Harm

BackgroundWe describe a national cohort of individuals surviving an episode of deliberate self-harm (DSH). Subsequent admissions for DSH and mortality over the following 13 years were studied.MethodIn 1981, 8304 individuals were discharged from Scottish general hospitals with a diagnosis of attempted suicide (E950–959). They were followed-up to the end of 1994 using the Scottish Linked Data Set. Mortality was compared to the Scottish population using person-years analysis.Results2624 people (31.6%) were readmitted with further episodes of DSH. The median number of readmissions was I, range 1–137. The observed: expected ratio for all-cause mortality was 2.26 (95% CI 2.13–2.26). One hundred and sixty-eight people (2%) died from suicide, and 46 (0.6%) from undetermined causes. The observed: expected ratio for suicide plus undetermined deaths was 12.17 (95% CI 10.64-13.91). Accidental deaths in men and homicide deaths in men and women were elevated. The pattern of deaths from other causes suggested that alcohol misuse was a contributory factor.ConclusionsPeople admitted to general hospitals in Scotland after attempted suicide are at high risk of readmission for further episodes of DSH. Long-term follow-up of such large cohorts is impractical, but services should review the scope for intervention in alcohol misuse following DSH.

scholarly journals Epidemiology and trends in non-fatal self-harm in three centres in England: 2000–2007

2010 ◽  
Vol 197 (6) ◽  
pp. 493-498 ◽  
Author(s):  
Helen Bergen ◽  
Keith Hawton ◽  
Keith Waters ◽  
Jayne Cooper ◽  
Navneet Kapur
Keyword(s):  
General Hospital ◽  
Strong Association ◽  
Prevention Policy ◽  
Hospital Emergency ◽  
Important Indicator ◽  
Self Injury ◽  
Self Harm ◽  
The Uk ◽  
National Trends ◽  
Hospital Emergency Departments

BackgroundSelf-harm is a common reason for presentation to a general hospital, with a strong association with suicide. Trends in self-harm are an important indicator of community psychopathology, with resource implications for health services and relevance to suicide prevention policy. Previous reports in the UK have come largely from single centres.AimsTo investigate trends in non-fatal self-harm in six general hospitals in three centres from the Multicentre Study of Self-harm in England, and to relate these to trends in suicide.MethodData on self-harm presentations to general hospital emergency departments in Oxford (one), Manchester (three) and Derby (two) were analysed over the 8-year period 1 January 2000 to 31 December 2007.ResultsRates of self-harm declined significantly over 8 years for males in three centres (Oxford: −14%; Manchester: −25%; Derby: −18%) and females in two centres (Oxford: −2% (not significant); Manchester: −13%; Derby: −17%), in keeping with national trends in suicide. A decreasing proportion and number of episodes involved self-poisoning alone, and an increasing proportion and number involved other self-injury (e.g. hanging, jumping, traffic related). Episodes involving self-cutting alone showed a slight decrease in numbers over time. Trends in alcohol use at the time of self-harm and repetition within 1 year were stable.ConclusionsThere were decreasing rates of non-fatal self-harm over the study period that paralleled trends in suicide in England. This was reflected mainly in a decline in emergency department presentations for self-poisoning.

The Epidemiology of Deliberate Self-harm

1986 ◽  
Vol 149 (6) ◽  
pp. 734-737 ◽  
Author(s):  
A. O. Odejide ◽  
A. O. Williams ◽  
J. U. Ohaeri ◽  
B. A. Ikuesan
Keyword(s):  
Prospective Study ◽  
Interpersonal Relationships ◽  
Psychotropic Drugs ◽  
General Hospitals ◽  
Female Ratio ◽  
Deliberate Self Harm ◽  
Self Harm ◽  
Male To Female ◽  
Ibadan Nigeria

In a 6-month prospective study of the three main general hospitals in Ibadan, Nigeria, 39 cases of deliberate self-harm were reported out of a total 23, 859 subjects attending the sections of hospital studied. Thirty (76.9%) were under 30 years of age and 36 (86.3%) were under 34 years of age. The male to female ratio was 1.4.1: more than half of the population (51.3%) were students and 25.6%, manual workers. The methods used were mainly ingestion of chemicals (24 patients) and psychotropic drugs (11 patients). Disturbed Interpersonal relationships, especially with parents, were mainly found to have motivated the acts. The implications of these findings are discussed.

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