Deliberate self-harm

In England and Wales there are at least 200,000 general hospital presentations for self-harm (intentional self-poisoning or self-injury) per year

• self-harm occurs in relation to a wide range of personal problems, emotional turmoil and psychiatric disorders. It carries a significant risk of subsequent suicide and has major impacts on family members and friends

Deliberate self-harm is defined as any act undertaken by a person mimicking the act of suicide, but not resulting in a fatal outcome.

Parasuicide is a very different phenomenon from suicide, not least in that there is a patient with which the health professional may work after the attempt.

• data from the Multicentre Study on Self Harm in England (1)
  • 57% of patients were female
  • 66% under 35 years of age
  • llargest numbers by age groups were 15-19 year-old females and 20-24 year-old males
  • female to male ratio decreased with age
  • approximately 80% of self-harm episodes involved self-poisoning
    • overdoses of paracetamol, the most frequent method, were more common in younger age groups, antidepressants in middle age groups, and benzodiazepines and sedatives in older age groups
    • alcohol was involved in more than half of assessed episodes
    • most common time of presentation to hospital was between 10pm and 2am
      
      
• a survey of young people aged 15-16 years estimated that more than 10% of girls and more than 3% of boys had self-harmed in the previous year (2)
  • self-harm increases the likelihood that the person will eventually die by suicide
    • by between 50- and 100-fold above the rest of the population in a 12-month period

Reference:

• Multicentre Study on Self Harm in England. Oxford University (Accessed 19/6/2014)
• Self-harm (longer term management), NICE Clinical Guideline (November 2011)