Hospital care and repetition following self-harm: multicentre comparison of self-poisoning and self-injury
Rachael Lilley,David Owens,Judith Horrocks,Allan House,Rachael Noble,Helen A. Bergen,Keith Hawton,Deborah Casey,Sue Simkin,Elizabeth Murphy,Jayne Cooper,Navneet Kapur +11 more
TLDR
Hospital services offer less to people who have cut themselves, although they are far more likely to repeat, than to those who have self-poisoned, and attendance at hospital should result in psychosocial assessment of needs regardless of method of self-harm.Abstract:
Background
Quantitative research about self-harm largely deals with self-poisoning, despite the high incidence of self-injury.
Aims
We compared patterns of hospital care and repetition associated with self-poisoning and self-injury.
Method
Demographic and clinical data were collected in a multicentre, prospective cohort study, involving 10 498 consecutive episodes of self-harm at six English teaching hospitals.
Results
Compared with those who self-poisoned, people who cut themselves were more likely to have self-harmed previously and to have received support from mental health services, but they were far less likely to be admitted to the general hospital or receive a psychosocial assessment. Although only 17% of people repeated self-harm during the 18 months of study, survival analysis that takes account of all episodes revealed a repetition rate of 33% in the year following an episode: 47% after episodes of self-cutting and 31% after self-poisoning ( P <0.001). Of those who repeated, a third switched method of self-harm.
Conclusions
Hospital services offer less to people who have cut themselves, although they are far more likely to repeat, than to those who have self-poisoned. Attendance at hospital should result in psychosocial assessment of needs regardless of method of self-harm.read more
Citations
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Journal ArticleDOI
Risk of suicide and repeat self-harm after hospital attendance for non-fatal self-harm in Sri Lanka: a cohort study
Duleeka Knipe,Chris Metcalfe,Keith Hawton,Melissa Pearson,Andrew H. Dawson,Shaluka Jayamanne,Flemming Konradsen,Michael Eddleston,Michael Eddleston,David Gunnell +9 more
TL;DR: A higher risk of repeat self-harm was observed in men than in women, and suicide in individuals aged 56 years and older compared with those aged 10–25 years, and those who used methods other than poisoning in their index presentation.
Journal ArticleDOI
Risk assessment following self-harm: comparison of mental health nurses and psychiatrists.
TL;DR: The finding that risk assessments were comparable by profession supports the provision of nurse-led assessment services, however, inpatient admission was influenced largely by assessor type rather than patient characteristics.
Journal ArticleDOI
Self-harm presentation across healthcare settings by sex in young people: an e-cohort study using routinely collected linked healthcare data in Wales, UK
Amanda Marchant,Samantha Turner,Lloyd Balbuena,Evyn M. Peters,Dave Williams,Keith Lloyd,Ronan A Lyons,Ann John +7 more
TL;DR: The first study to compare self-harm in people aged 10–24 years across primary care, emergency departments, outpatients and hospital settings in the UK highlights these as important settings for intervention.
Journal ArticleDOI
Violence, self-harm and drug or alcohol misuse in adolescents admitted to hospitals in England for injury: a retrospective cohort study
TL;DR: Hospital-based interventions should be developed to reduce the risk of future injury in adolescents admitted for adversity-related injury.
Book
The psychopathology of women
TL;DR: In this article, the authors discuss the specific challenges that women face in the health system, including the lack of access that suffers much of the world's female population, and defend a change of approach to the women's health issues whenever they need to use the health systems.
References
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