Self-harm and life problems: findings from the Multicentre Study of Self-harm in England
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Self-harm is a major clinical problem and is strongly linked to suicide. It is important to understand the problems faced by those who self-harm to design effective clinical services and suicide prevention strategies. We investigated the life problems experienced by patients presenting to general hospitals for self-harm.
Data for 2000–2010 from the Multicentre Study of Self-harm in England were used to investigate life problems associated with self-harm and their relationship to patient and clinical characteristics, including age, gender, repeat self-harm and employment status.
Of 24,598 patients (36,431 assessed episodes), 57 % were female and with a mean age of 33.1 years (SD 14.0 years), 92.6 % were identified as having at least one contributing life problem. The most frequently reported problems at first episode of self-harm within the study period were relationship difficulties (especially with partners). Mental health issues and problems with alcohol were also very common (especially in those aged 35–54 years, and those who repeated self-harm). Those who repeated self-harm were more likely to report problems with housing, mental health and dealing with the consequences of abuse.
Self-harm usually occurs in the context of multiple life problems. Clinical services for self-harm patients should have access to appropriate care for provision of help for relationship difficulties and problems concerning alcohol and mental health issues. Individualised clinical support (e.g. psychological therapy, interventions for alcohol problems and relationship counselling) for self-harm patients facing these life problems may play a crucial role in suicide prevention.
KeywordsSelf-harm Life problems Age Gender Repetition
The authors from Derby would like to thank the clinicians, clerical and administrative staff in the liaison team (formerly the mental health liaison team) and emergency department. The authors from Oxford would like to thank Deborah Casey, Elizabeth Bale, Dorothy Rutherford and clinical and administrative staff for assistance with self-harm data collection. The authors from Manchester would like to thank Iain Donaldson, Victoria Matthews and Harriet Bickley for assistance with data collection, and members of the general hospital psychiatric and other clinical services, and hospital administration staff.
We acknowledge financial support from the Department of Health. Keith Hawton is a National Institute for Health Research (NIHR) Senior Investigator. The Department of Health and NIHR had no role in study design, the collection, analysis and interpretation of data, the writing of the report, and the decision to submit the paper for publication. The views and opinions expressed within this paper are those of the authors and do not necessarily reflect those of NIHR or the Department of Health.
Compliance with ethical standards
Conflict of interest
On behalf of all authors, the corresponding author states that there is no conflict of interest.
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