Increasing rates of self-harm among children, adolescents and young adults: a 10-year national registry study 2007–2016

Abstract

Purpose

Rates of hospital-treated self-harm are highest among young people. The current study examined trends in rates of self-harm among young people in Ireland over a 10-year period, as well as trends in self-harm methods.

Methods

Data from the National Self-Harm Registry Ireland on presentations to hospital emergency departments (EDs) following self-harm by those aged 10–24 years during the period 2007–2016 were included. We calculated annual self-harm rates per 100,000 by age, gender and method of self-harm. Poisson regression models were used to examine trends in rates of self-harm.

Results

The average person-based rate of self-harm among 10–24-year-olds was 318 per 100,000. Peak rates were observed among 15–19-year-old females (564 per 100,000) and 20–24-year-old males (448 per 100,000). Between 2007 and 2016, rates of self-harm increased by 22%, with increases most pronounced for females and those aged 10–14 years. There were marked increases in specific methods of self-harm, including those associated with high lethality.

Conclusions

The findings indicate that the age of onset of self-harm is decreasing. Increasing rates of self-harm, along with increases in highly lethal methods, indicate that targeted interventions in key transition stages for young people are warranted.

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References

  1. 1.

    Hawton K, Saunders KE, O’Connor RC (2012) Self-harm and suicide in adolescents. Lancet 379:2373–2382

    Article  PubMed  Google Scholar 

  2. 2.

    Morey C, Corcoran P, Arensman E, Perry IJ (2008) The prevalence of self-reported deliberate self harm in Irish adolescents. BMC Public Health 8:79

    Article  PubMed  PubMed Central  Google Scholar 

  3. 3.

    Madge N, Hewitt A, Hawton K, de Wilde EJ, Corcoran P, Fekete S, van Heeringen K, De Leo D, Ystgaard M (2008) Deliberate self-harm within an international community sample of young people: comparative findings from the Child and Adolescent Self-harm in Europe (CASE) Study. J Child Psychol Psychiatry 49:667–677

    Article  PubMed  Google Scholar 

  4. 4.

    Hawton K, Rodham K, Evans E, Weatherall R (2002) Deliberate self harm in adolescents: self report survey in schools in England. BMJ 325:1207–1211

    Article  PubMed  PubMed Central  Google Scholar 

  5. 5.

    Marchant A, Hawton K, Stewart A, Montgomery P, Singaravelu V, Lloyd K, Purdy N, Daine K, John A (2017) A systematic review of the relationship between internet use, self-harm and suicidal behaviour in young people: the good, the bad and the unknown. PLoS One 12:e0181722

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  6. 6.

    Jacob N, Evans R, Scourfield J (2017) The influence of online images on self-harm: a qualitative study of young people aged 16–24. J Adolesc 60:140–147

    Article  PubMed  PubMed Central  Google Scholar 

  7. 7.

    Geulayov G, Kapur N, Turnbull P, Clements C, Waters K, Ness J, Townsend E, Hawton K (2016) Epidemiology and trends in non-fatal self-harm in three centres in England, 2000–2012. Findings from the Multicentre Study of Self-harm in England. BMJ Open 6:e010538

    Article  PubMed  PubMed Central  Google Scholar 

  8. 8.

    Department of Health (2015) Connecting for Life: Ireland’s National Strategy to reduce suicide (2015–2020). Department of Health, Dublin

    Google Scholar 

  9. 9.

    Griffin E, Arensman E, Dillon CB, Corcoran P, Williamson E, Perry IJ (2017) National self-harm registry annual report 2016. National Suicide Research Foundation, Cork

    Google Scholar 

  10. 10.

    Bergen H, Hawton K, Waters K, Ness J, Cooper J, Steeg S, Kapur N (2012) Premature death after self-harm: a multicentre cohort study. Lancet 380:1568–1574

    Article  PubMed  Google Scholar 

  11. 11.

    Runeson B, Tidemalm D, Dahlin M, Lichtenstein P, Langstrom N (2010) Method of attempted suicide as predictor of subsequent successful suicide: national long term cohort study. BMJ 341:c3222

    Article  PubMed  PubMed Central  Google Scholar 

  12. 12.

    Diggins E, Kelley R, Cottrell D, House A, Owens D (2017) Age-related differences in self-harm presentations and subsequent management of adolescents and young adults at the emergency department. J Affect Disord 208:399–405

    Article  PubMed  Google Scholar 

  13. 13.

    Vancayseele N, Portzky G, van Heeringen K (2016) Increase in self-injury as a method of self-harm in Ghent, Belgium: 1987–2013. PLoS One 11:e0156711

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  14. 14.

    Rhodes AE, Bethell J, Carlisle C, Rosychuk RJ, Lu H, Newton A (2014) Time trends in suicide-related behaviours in girls and boys. Can J Psychiatry 59:152–159

    Article  PubMed  PubMed Central  Google Scholar 

  15. 15.

    Hawton K, Haw C, Casey D, Bale L, Brand F, Rutherford D (2015) Self-harm in Oxford, England: epidemiological and clinical trends, 1996–2010. Soc Psychiatry Psychiatr Epidemiol 50:695–704

    Article  PubMed  Google Scholar 

  16. 16.

    Carr MJ, Ashcroft DM, Kontopantelis E, Awenat Y, Cooper J, Chew-Graham C, Kapur N, Webb RT (2016) The epidemiology of self-harm in a UK-wide primary care patient cohort, 2001–2013. BMC Psychiatry 16:53

    Article  PubMed  PubMed Central  Google Scholar 

  17. 17.

    Platt S, Bille-Brahe U, Kerkhof A, Schmidtke A, Bjerke T, Crepet P, De Leo D, Haring C, Lonnqvist J, Michel K et al (1992) Parasuicide in Europe: the WHO/EURO multicentre study on parasuicide. I. Introduction and preliminary analysis for 1989. Acta Psychiatr Scand 85:97–104

    Article  PubMed  CAS  Google Scholar 

  18. 18.

    Perry IJ, Corcoran P, Fitzgerald AP, Keeley HS, Reulbach U, Arensman E (2012) The incidence and repetition of hospital-treated deliberate self harm: findings from the world’s first national registry. PloS One 7:e31663

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  19. 19.

    World Health Organization (2010) International classification of diseases and related health outcomes. 10th Revision (ICD-10) Version for 2010. WHO, 2010. http://apps.who.int/classifications/icd10/browse/2010/en#/X60-X84. Accessed 8 Feb 2018

  20. 20.

    Morgan C, Webb RT, Carr MJ, Kontopantelis E, Green J, Chew-Graham CA, Kapur N, Ashcroft DM (2017) Incidence, clinical management, and mortality risk following self harm among children and adolescents: cohort study in primary care. BMJ 359:j4351

    Article  PubMed  PubMed Central  Google Scholar 

  21. 21.

    Corcoran P, Griffin E, Arensman E, Fitzgerald AP, Perry IJ (2015) Impact of the economic recession and subsequent austerity on suicide and self-harm in Ireland: An interrupted time series analysis. Int J Epidemiol 44:969–977

    Article  PubMed  Google Scholar 

  22. 22.

    Bor W, Dean AJ, Najman J, Hayatbakhsh R (2014) Are child and adolescent mental health problems increasing in the 21st century? A systematic review. Aust N Z J Psychiatry 48:606–616

    Article  PubMed  Google Scholar 

  23. 23.

    Bennardi M, McMahon E, Corcoran P, Griffin E, Arensman E (2016) Risk of repeated self-harm and associated factors in children, adolescents and young adults. BMC Psychiatry 16:421

    Article  PubMed  PubMed Central  Google Scholar 

  24. 24.

    Wasserman D, Hoven CW, Wasserman C, Wall M, Eisenberg R, Hadlaczky G, Kelleher I, Sarchiapone M, Apter A, Balazs J et al (2015) School-based suicide prevention programmes: the SEYLE cluster-randomised, controlled trial. Lancet 385:1536–1544

    Article  PubMed  Google Scholar 

  25. 25.

    Arnett JJ, Zukauskiene R, Sugimura K (2014) The new life stage of emerging adulthood at ages 18–29 years: implications for mental health. Lancet Psychiatry 1:569–576

    Article  PubMed  Google Scholar 

  26. 26.

    Beckman K, Mittendorfer-Rutz E, Lichtenstein P, Larsson H, Almqvist C, Runeson B, Dahlin M (2016) Mental illness and suicide after self-harm among young adults: long-term follow-up of self-harm patients, admitted to hospital care, in a national cohort. Psychol Med 46:3397–3405

    Article  PubMed  CAS  Google Scholar 

  27. 27.

    Tanner JL, Arnett JJ (2013) Approaching young adult health and medicine from a developmental perspective. Adolesc Med State Art Rev 24:485–506

    PubMed  Google Scholar 

  28. 28.

    Singh SP, Paul M, Ford T, Kramer T, Weaver T, McLaren S, Hovish K, Islam Z, Belling R, White S (2010) Process, outcome and experience of transition from child to adult mental healthcare: multiperspective study. Br J Psychiatry 197:305–312

    Article  PubMed  Google Scholar 

  29. 29.

    McNamara N, McNicholas F, Ford T, Paul M, Gavin B, Coyne I, Cullen W, O’Connor K, Ramperti N, Dooley B et al (2014) Transition from child and adolescent to adult mental health services in the Republic of Ireland: an investigation of process and operational practice. Early Interv Psychiatry 8:291–297

    Article  PubMed  Google Scholar 

  30. 30.

    McNicholas F, Adamson M, McNamara N, Gavin B, Paul M, Ford T, Barry S, Dooley B, Coyne I, Cullen W, Singh SP (2015) Who is in the transition gap? Transition from CAMHS to AMHS in the Republic of Ireland. Ir J Psychol Med 32:61–69

    Article  CAS  PubMed  Google Scholar 

  31. 31.

    Hawton K, Bergen H, Kapur N, Cooper J, Steeg S, Ness J, Waters K (2012) Repetition of self-harm and suicide following self-harm in children and adolescents: findings from the multicentre study of self-harm in England. J Child Psychol Psychiatry 53:1212–1219

    Article  PubMed  Google Scholar 

  32. 32.

    Larkin C, Corcoran P, Perry I, Arensman E (2014) Severity of hospital-treated self-cutting and risk of future self-harm: a national registry study. J Ment Health 23:115–119

    Article  PubMed  Google Scholar 

  33. 33.

    Lathi A, Harju A, Hakko H, Riala K, Räsänen P (2014) Suicide in children and young adolescents: a 25-year database on suicides from Northern Finland. J Psychiatr Res 58:123–128

    Article  Google Scholar 

  34. 34.

    Bergen H, Hawton K, Waters K, Ness J, Cooper J, Steeg S, Kapur N (2012) How do methods of non-fatal self-harm relate to eventual suicide? J Affect Disord 136:526–533

    Article  PubMed  Google Scholar 

  35. 35.

    Rodway C, Tham SG, Ibrahim S, Turnbull P, Windfuhr K, Shaw J, Kapur N, Appleby L (2016) Suicide in children and young people in England: a consecutive case series. Lancet Psychiatry 3:751–759

    Article  PubMed  Google Scholar 

  36. 36.

    Austin AE, van den Heuvel C, Byard RW (2011) Cluster hanging suicides in the young in South Australia. J Forensic Sci 56:1528–1530

    Article  PubMed  Google Scholar 

  37. 37.

    Hawton K, Hall S, Simkin S, Bale L, Bond A, Codd S, Stewart A (2003) Deliberate self-harm in adolescents: a study of characteristics and trends in Oxford, 1990–2000. J Child Psychol Psychiatry 44:1191–1198

    Article  PubMed  Google Scholar 

  38. 38.

    Rhodes AE, Boyle MH, Bridge JA, Sinyor M, Links PS, Tonmyr L et al (2014) Antecedents and sex/gender differences in youth suicidal behavior. World J Psychiatry 4(4):120–132. https://doi.org/10.5498/wjp.v4.i4.120

    Article  PubMed  PubMed Central  Google Scholar 

  39. 39.

    McMahon EM, Keeley H, Cannon M, Arensman E, Perry IJ, Clarke M, Chambers D, Corcoran P (2014) The iceberg of suicide and self-harm in Irish adolescents: a population-based study. Soc Psychiatry Psychiatr Epidemiol 49:1929–1935

    Article  PubMed  Google Scholar 

  40. 40.

    Hawton K, Witt KG, Taylor Salisbury TL, Arensman E, Gunnell D, Townsend E, van Heeringen K, Hazell P (2015) Interventions for self-harm in children and adolescents. Cochrane Database Syst Rev 12:CD012013. https://doi.org/10.1002/14651858.CD012013

    Article  Google Scholar 

  41. 41.

    Bergen H, Hawton K, Waters K, Cooper J, Kapur N (2010) Epidemiology and trends in non-fatal self-harm in three centres in England: 2000–2007. Br J Psychiatry 197:493–498

    Article  PubMed  Google Scholar 

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Acknowledgements

The National Self-Harm Registry Ireland is funded by the Irish Health Service Executive’s National Office for Suicide Prevention.

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Correspondence to Eve Griffin.

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None declared.

Ethics statement

The National Research Ethics Committee of the Faculty of Public Health Medicine, Ireland granted ethical approval for the National Self-Harm Registry Ireland.

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Griffin, E., McMahon, E., McNicholas, F. et al. Increasing rates of self-harm among children, adolescents and young adults: a 10-year national registry study 2007–2016. Soc Psychiatry Psychiatr Epidemiol 53, 663–671 (2018). https://doi.org/10.1007/s00127-018-1522-1

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Keywords

  • Self-harm
  • Young people
  • Epidemiology