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.

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 Self-harm during the early period of the COVID-19 Pandemic in England: comparative trend analysis of hospital presentations

2020 ◽  
Author(s):  
Keith Hawton ◽  
Deborah Casey ◽  
Elizabeth Bale ◽  
Fiona Brand ◽  
Jennifer Ness ◽  
...  
Keyword(s):  
Help Seeking ◽  
Age Groups ◽  
Early Period ◽  
Psychosocial Assessment ◽  
Health Measures ◽  
Self Injury ◽  
Self Harm ◽  
Substantial Decline ◽  
The Uk ◽  
Term Monitoring

ABSTRACTBackgroundThe COVID-19 pandemic and public health measures necessary to address it may have major effects on mental health, including on self-harm. We have used well-established monitoring systems in two hospitals in England to investigate trends in self-harm presentations to hospitals during the early period of the pandemic.MethodData collected in Oxford and Derby on patients aged 18 years and over who received a psychosocial assessment after presenting to the emergency departments following self-harm were used to compare trends during the three-month period following lockdown in the UK (23rd March 2020) to the period preceding lockdown and the equivalent period in 2019.ResultsDuring the 12 weeks following introduction of lockdown restrictions there was a large reduction in the number of self-harm presentations to hospitals by individuals aged 18 years and over compared to the pre-lockdown weeks in 2020 (mean weekly reduction of 13.5 (95% CI 5.6 - 21.4) and the equivalent period in 2019 (mean weekly reduction of 18.0 (95% CI 13.9 - 22.1). The reduction was greater in females than males, occurred in all age groups, with a larger reduction in presentations following self-poisoning than self-injury.ConclusionsA substantial decline in hospital presentations for self-harm occurred during the three months following the introduction of lockdown restrictions. Reasons could include a reduction in self-harm at the community level and individuals avoiding presenting to hospital following self-harm. Longer-term monitoring of self-harm behaviour during the pandemic is essential, together with efforts to encourage help-seeking and the modification of care provision.

Self-harm

2020 ◽  
pp. 6457-6460
Author(s):  
Kate E.A. Saunders ◽  
Keith Hawton
Keyword(s):  
Mood Disorder ◽  
Psychiatric Disorders ◽  
Emotional Disturbance ◽  
Suicide Risk ◽  
Psychological Intervention ◽  
Hospital Emergency ◽  
Psychiatric Assessment ◽  
Self Harm ◽  
Hospital Emergency Departments ◽  
Careful Assessment

Self-harm is one of the commonest reasons people present to hospital emergency departments and the most frequent form of self-harm is overdose. Most patients who self-harm have an emotional disturbance, commonly an adjustment or mood disorder, often in a context of situational or relationship stresses, and personality difficulties. Some have more severe psychiatric disorders. Intoxication with alcohol is common. All patients presenting with self-harm require both a medical and a psychiatric assessment. The latter should include an assessment of problems, needs and suicide risk. Children require particularly careful assessment. In assessing suicide risk, it should be noted that the medical dangerousness of the act does not necessarily reflect the intent, and that repeat self-harm greatly increases the risk of eventual suicide. Psychiatric management depends on the patient's problems and diagnosis. There is some evidence that brief psychological intervention can decrease the risk of repeat self-harm.

Police Referrals to a Psychiatric Hospital: Indicators for Referral and Psychiatric Outcome

1994 ◽  
Vol 28 (2) ◽  
pp. 259-268 ◽  
Author(s):  
Graham Meadows ◽  
Greg Calder ◽  
Hans van Den Bos
Keyword(s):  
Mental Illness ◽  
Psychotic Symptoms ◽  
Relative Odds ◽  
Self Injury ◽  
Language Difficulties ◽  
The Usa ◽  
Self Harm ◽  
Clinical Description ◽  
The Uk ◽  
Psychiatric Outcome

Studies of police psychiatric referrals in the USA and the UK generally show these patients to be ill and in need of care. There are, however, no published Australian studies and such findings may not be validly generalised. This prospective study of consecutive police psychiatric referrals in Adelaide reports psychiatric assessment in 92 cases and observations by police in 69 of these, with no evidence of selection bias. The most common reason for referral was threat of self harm (28%). Mental illness was deemed to be present in 49% and the most common clinical description was “situational crisis” (29%). Schizophrenia was diagnosed in 18%. Clinicians viewed 19% of referrals as inappropriate. Increased relative odds for mental illness were associated with police accounts of psychotic symptoms, and decreased odds with threat of self harm and violence. Increased odds for admission were associated with language difficulties and damage to own property, decreased odds with threat to others, threat of suicide, and threat to self injury. There were 14 cases where possible charges were not being pursued: of these 7 were regarded as ill and 4 were regarded as inappropriate referrals. The rates of major disorders are lower than in other published work. It is proposed that this can be explained by relative ease of referral by police to psychiatry and flexible acceptance criteria.

scholarly journals The use of restraint in four general hospital emergency departments in Australia

2014 ◽  
Vol 22 (4) ◽  
pp. 366-369 ◽  
Author(s):  
Adam Gerace ◽  
Dewi R Pamungkas ◽  
Candice Oster ◽  
Del Thomson ◽  
Eimear Muir-Cochrane
Keyword(s):  
General Hospital ◽  
Emergency Departments ◽  
Hospital Emergency ◽  
Hospital Emergency Departments

scholarly journals A Qualitative Study of Understanding Reasons for Self-Harm in Adolescent Girls

2021 ◽  
Vol 18 (7) ◽  
pp. 3361
Author(s):  
Michelle Miller ◽  
Marcus Redley ◽  
Paul O. Wilkinson
Keyword(s):  
Qualitative Study ◽  
Interpersonal Relationships ◽  
Adolescent Girls ◽  
Interpretative Phenomenological Analysis ◽  
Public Health Issue ◽  
Self Injury ◽  
Compulsive Behaviour ◽  
Self Harm ◽  
New Perspective ◽  
The Uk

Objective: Self-harm is an important public health issue in the UK. Young people who frequently self-harm feel misunderstood, and unable to access help. Improving understanding is key to informing the development and delivery of effective treatments and services. Methods: In this qualitative study, we interviewed nine adolescent girls (13–17 years old) with recurrent self-harm, recruited from NHS specialist child and adolescent mental health services. Data were analysed using Interpretative Phenomenological Analysis (IPA). Results: Findings revealed that self-harm is experienced as powerful mental and physical urges, sated only by self-harming, suggesting that self-harm could be considered a compulsive rather than impulsive disorder, representing a new perspective on the behaviour. Five themes emerged: emotion regulation; an addictive urge; self-harm to survive; interpersonal triggers; interpersonal relationships, not mechanical distractors, reduce self-harm. Conclusions: This study provides further evidence that non-suicidal self-injury may be engaged in to reduce suicidal risk. Seeking the company of helpful friends or family members may reduce the urge to self-harm. Repetitive self-harm may be a compulsive behaviour.

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