The Basic Act for Suicide Prevention: Effects on Longitudinal Trend in Deliberate Self-Harm with Reference to National Suicide Data for 1996–2014

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.

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

Psychological Medicine ◽

10.1017/s0033291703007943 ◽

2003 ◽

Vol 33 (6) ◽

pp. 987-995 ◽

Cited By ~ 246

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.

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Suicide and deliberate self-harm

Shorter Oxford Textbook of Psychiatry ◽

10.1093/med/9780199605613.003.0016 ◽

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.

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Assessment of deliberate self-harm in adults

Advances in Psychiatric Treatment ◽

10.1192/apt.1.5.124 ◽

1995 ◽

Vol 1 (5) ◽

pp. 124-130 ◽

Cited By ~ 4

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.

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Selvmordsforebygging skal sitte i veggene: om bygging av nytt Østfoldsykehus

Suicidologi ◽

10.5617/suicidologi.2219 ◽

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.

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Coping Style as a Mediator of the Relationship Between Depressive Symptoms and Deliberate Self-Harm

Crisis ◽

10.1027/0227-5910/a000083 ◽

2011 ◽

Vol 32 (5) ◽

pp. 272-279 ◽

Cited By ~ 9

Author(s):

Allison S. Christian ◽

Kristen M. McCabe

Keyword(s):

Depressive Symptoms ◽

Undergraduate Students ◽

Cross Sectional Study ◽

Self Report ◽

Hierarchical Regression ◽

Cross Sectional ◽

Deliberate Self Harm ◽

Self Blame ◽

Self Harm ◽

The Relationship

Background: Deliberate self-harm (DSH) occurs with high frequency among clinical and nonclinical youth populations. Although depression has been consistently linked with the behavior, not all depressed individuals engage in DSH. Aims: The current study examined maladaptive coping strategies (i.e., self-blame, distancing, and self-isolation) as mediators between depression and DSH among undergraduate students. Methods: 202 students from undergraduate psychology courses at a private university in Southern California (77.7% women) completed anonymous self-report measures. Results: A hierarchical regression model found no differences in DSH history across demographic variables. Among coping variables, self-isolation alone was significantly related to DSH. A full meditational model was supported: Depressive symptoms were significantly related to DSH, but adding self-isolation to the model rendered the relationship nonsignificant. Limitations: The cross-sectional study design prevents determination of whether a casual relation exists between self-isolation and DSH, and obscures the direction of that relationship. Conclusions: Results suggest targeting self-isolation as a means of DSH prevention and intervention among nonclinical, youth populations.

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Negative Life Events Associated With Deliberate Self-Harm in an African Population in Uganda

Crisis ◽

10.1027/0227-5910.26.1.4 ◽

2005 ◽

Vol 26 (1) ◽

pp. 4-11 ◽

Cited By ~ 24

Author(s):

E. Kinyanda ◽

H. Hjelmeland ◽

S. Musisi

Keyword(s):

Life Events ◽

Negative Life Events ◽

Life Time ◽

Later Life ◽

Dose Effect ◽

Deliberate Self Harm ◽

Time Period ◽

Significant Difference ◽

Self Harm ◽

Suicide Interventions

Abstract. Negative life events associated with deliberate self-harm (DSH) were investigated in an African context in Uganda. Patients admitted at three general hospitals in Kampala, Uganda were interviewed using a Luganda version (predominant language in the study area) of the European Parasuicide Study Interview Schedule I. The results of the life events and histories module are reported in this paper. The categories of negative life events in childhood that were significantly associated with DSH included those related to parents, significant others, personal events, and the total negative life events load in childhood. For the later-life time period, the negative life events load in the partner category and the total negative life events in this time period were associated with DSH. In the last-year time period, the negative life events load related to personal events and the total number of negative life events in this time period were associated with DSH. A statistically significant difference between the cases and controls for the total number of negative life events reported over the entire lifetime of the respondents was also observed, which suggests a dose effect of negative life events on DSH. Gender differences were also observed among the cases. In conclusion, life events appear to be an important factor in DSH in this cultural environment. The implication of these results for treatment and the future development of suicide interventions in this country are discussed.

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Non-Fatal Deliberate Self-Harm in Three Remote Indigenous Communities in Far North Queensland, Australia

Crisis ◽

10.1027/0227-5910/a000589 ◽

2019 ◽

Vol 40 (6) ◽

pp. 422-428 ◽

Cited By ~ 1

Author(s):

Chris Rouen ◽

Alan R. Clough ◽

Caryn West

Keyword(s):

Health Care ◽

Primary Health Care ◽

Care Center ◽

Indigenous Communities ◽

Indigenous Australians ◽

Deliberate Self Harm ◽

Health Care Center ◽

Far North ◽

Primary Health ◽

Self Harm

Abstract. Background: Indigenous Australians experience a suicide rate over twice that of the general population. With nonfatal deliberate self-harm (DSH) being the single most important risk factor for suicide, characterizing the incidence and repetition of DSH in this population is essential. Aims: To investigate the incidence and repetition of DSH in three remote Indigenous communities in Far North Queensland, Australia. Method: DSH presentation data at a primary health-care center in each community were analyzed over a 6-year period from January 1, 2006 to December 31, 2011. Results: A DSH presentation rate of 1,638 per 100,000 population was found within the communities. Rates were higher in age groups 15–24 and 25–34, varied between communities, and were not significantly different between genders; 60% of DSH repetitions occurred within 6 months of an earlier episode. Of the 227 DSH presentations, 32% involved hanging. Limitations: This study was based on a subset of a larger dataset not specifically designed for DSH data collection and assesses the subset of the communities that presented to the primary health-care centers. Conclusion: A dedicated DSH monitoring study is required to provide a better understanding of DSH in these communities and to inform early intervention strategies.

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