Deliberate self‐harm (DSH) among older people: a retrospective study in Barnet, North London

Abstract

This study confirms the need for improved documentation of DSH and its coding; this needs to be reviewed at local and national level. The vast majority of older people who attempt suicide do have subsequent contact with psychiatric services. There is a strong likelihood of repeat DSH and a higher risk of death by natural causes, emphasising the need to conceptualise DSH as a risk factor relevant to all medical specialities.

Attempted Suicide in Older People: A Review of the Evidence

“…Of the 71 elderly Japanese attempters studied by Kato et al (2013), 78.9% presented with a physical disorder, compared with 20.6% in the non-elderly group. In contrast to these findings, Ruths et al (2005) UK study did not find any impact of physical health factors on deliberate self-harm behaviours in psychiatric patients. In addition to distress resulting from physical illness itself, findings from Yang et al (2001) Taiwanese study argue that the impact on lifestyle, discomfort associated with treatment, fear of being a family burden and loss of hope of recovery may contribute to an attempt.…”

“…As a contributing factor for suicide, physical illness inhabits a contentious space within the research literature (Ruths et al, 2005). Chan et al (2007) argued that physical health status did not appear to be strongly associated with deliberate self-harm.…”

“…In the study by Yang et al (2001), 60% of attempters were unmarried at the time of the attempt, with social isolation or loneliness cited as motives by twenty of the older Taiwanese attempters. In the study by Ruths et al (2005), married persons were under-represented, whilst widows were over-represented (41% and 45% respectively). Yang et al (2001) found that family problems accounted for approximately half of the attempts with some attempters attributing their motivation to children that were not filial.…”

“…Findings by Ruths et al (2005) revealed that 38% of people aged 65 years or over lived alone. Similarly, older attempters in the Swedish study by Wiktorsson et al (2010) were less likely to have a partner and lived alone more often than individuals in the comparison group.…”

“…Over half of the cases and one tenth of the individuals in the comparison group in the study by Wiktorsson et al (2010) had a history of psychiatric treatment. Ruths et al (2005) argued that the overall impact of psychiatric care on suicide and prevention of attempted suicide was unclear.…”