What happens after self-harm? An exploration of self-harm and suicide using the Northern Ireland Registry of Self-Harm

Background Suicide is a major public health concern and Northern Ireland (NI) has the highest rate of both self-harm and suicide in the UK and Ireland. In order to target prevention strategies effectively, it is vital to understand who is most at risk. Aim To explore the risk factors for com...

Full description

Bibliographic Details
Main Authors: Aideen Maguire, Emma Ross, Foteini Tseliou, Denise O'Hagan, Dermot O'Reilly
Format: Article
Language:English
Published: Swansea University 2019-11-01
Series:International Journal of Population Data Science
Online Access:https://ijpds.org/article/view/1186
_version_ 1797427911207157760
author Aideen Maguire
Emma Ross
Foteini Tseliou
Denise O'Hagan
Dermot O'Reilly
author_facet Aideen Maguire
Emma Ross
Foteini Tseliou
Denise O'Hagan
Dermot O'Reilly
author_sort Aideen Maguire
collection DOAJ
description Background Suicide is a major public health concern and Northern Ireland (NI) has the highest rate of both self-harm and suicide in the UK and Ireland. In order to target prevention strategies effectively, it is vital to understand who is most at risk. Aim To explore the risk factors for completed suicide following presentation with self-harm. Methods The Northern Ireland Registry of Self-Harm (NIRSH) collects information on all self-harm and suicide ideation presentations to all Emergency Departments in NI. NIRSH data from 2012-2015 was linked to centralised electronic data relating to primary care, prescribed medication and mortality records. Logistic regression was employed to quantify the likelihood of mortality with adjustment for factors associated with mental ill health and suicide risk, and Cox regression was used to explore which characteristics of those who self-harm are most associated with risk of suicide. Results The cohort consisted of all 1,483,435 individuals born or resident in NI from 1st January 1970 until 31st December 2015 (maximum age in 2015, 45 years). During the follow-up period, 12,327 (0.8%) individuals presented with self-harm and 892 (0.1%) died by suicide. Rates of self-harm were equivalent for males and females with highest rates observed in the 18-24 years age group, and more common in deprived than affluent areas (OR=3.42, 95%CI 3,21, 3.65). Most individuals self-harmed via self-poisoning with psychotropic medications (71.5%), followed by self-injury with a sharp object (21.7%). Although only 162 (1.3%) of those who presented with self-harm went on to die by suicide, those who presented with self-harm were 24 times more likely to die by suicide compared to those who did not present with self-harm after adjustment for age and sex (HR=24.3, 95%CI 20.46,28.76). Conclusion This constitutes the first population-wide study of self-harm in the UK and could be utilised to inform suicide prevention strategies.
first_indexed 2024-03-09T08:51:40Z
format Article
id doaj.art-f3235b92e0694fdf9a1f2a3ab4b3e7f7
institution Directory Open Access Journal
issn 2399-4908
language English
last_indexed 2024-03-09T08:51:40Z
publishDate 2019-11-01
publisher Swansea University
record_format Article
series International Journal of Population Data Science
spelling doaj.art-f3235b92e0694fdf9a1f2a3ab4b3e7f72023-12-02T14:19:21ZengSwansea UniversityInternational Journal of Population Data Science2399-49082019-11-014310.23889/ijpds.v4i3.1186What happens after self-harm? An exploration of self-harm and suicide using the Northern Ireland Registry of Self-HarmAideen Maguire0Emma Ross1Foteini Tseliou2Denise O'Hagan3Dermot O'Reilly4Queen's University BelfastQueen's University BelfastCardiff UniversityPublic Health AgencyQueen's University BelfastBackground Suicide is a major public health concern and Northern Ireland (NI) has the highest rate of both self-harm and suicide in the UK and Ireland. In order to target prevention strategies effectively, it is vital to understand who is most at risk. Aim To explore the risk factors for completed suicide following presentation with self-harm. Methods The Northern Ireland Registry of Self-Harm (NIRSH) collects information on all self-harm and suicide ideation presentations to all Emergency Departments in NI. NIRSH data from 2012-2015 was linked to centralised electronic data relating to primary care, prescribed medication and mortality records. Logistic regression was employed to quantify the likelihood of mortality with adjustment for factors associated with mental ill health and suicide risk, and Cox regression was used to explore which characteristics of those who self-harm are most associated with risk of suicide. Results The cohort consisted of all 1,483,435 individuals born or resident in NI from 1st January 1970 until 31st December 2015 (maximum age in 2015, 45 years). During the follow-up period, 12,327 (0.8%) individuals presented with self-harm and 892 (0.1%) died by suicide. Rates of self-harm were equivalent for males and females with highest rates observed in the 18-24 years age group, and more common in deprived than affluent areas (OR=3.42, 95%CI 3,21, 3.65). Most individuals self-harmed via self-poisoning with psychotropic medications (71.5%), followed by self-injury with a sharp object (21.7%). Although only 162 (1.3%) of those who presented with self-harm went on to die by suicide, those who presented with self-harm were 24 times more likely to die by suicide compared to those who did not present with self-harm after adjustment for age and sex (HR=24.3, 95%CI 20.46,28.76). Conclusion This constitutes the first population-wide study of self-harm in the UK and could be utilised to inform suicide prevention strategies.https://ijpds.org/article/view/1186
spellingShingle Aideen Maguire
Emma Ross
Foteini Tseliou
Denise O'Hagan
Dermot O'Reilly
What happens after self-harm? An exploration of self-harm and suicide using the Northern Ireland Registry of Self-Harm
International Journal of Population Data Science
title What happens after self-harm? An exploration of self-harm and suicide using the Northern Ireland Registry of Self-Harm
title_full What happens after self-harm? An exploration of self-harm and suicide using the Northern Ireland Registry of Self-Harm
title_fullStr What happens after self-harm? An exploration of self-harm and suicide using the Northern Ireland Registry of Self-Harm
title_full_unstemmed What happens after self-harm? An exploration of self-harm and suicide using the Northern Ireland Registry of Self-Harm
title_short What happens after self-harm? An exploration of self-harm and suicide using the Northern Ireland Registry of Self-Harm
title_sort what happens after self harm an exploration of self harm and suicide using the northern ireland registry of self harm
url https://ijpds.org/article/view/1186
work_keys_str_mv AT aideenmaguire whathappensafterselfharmanexplorationofselfharmandsuicideusingthenorthernirelandregistryofselfharm
AT emmaross whathappensafterselfharmanexplorationofselfharmandsuicideusingthenorthernirelandregistryofselfharm
AT foteinitseliou whathappensafterselfharmanexplorationofselfharmandsuicideusingthenorthernirelandregistryofselfharm
AT deniseohagan whathappensafterselfharmanexplorationofselfharmandsuicideusingthenorthernirelandregistryofselfharm
AT dermotoreilly whathappensafterselfharmanexplorationofselfharmandsuicideusingthenorthernirelandregistryofselfharm