Self-harm amongst people of Chinese origin versus White people living in England: a cohort study

Abstract

BackgroundThere has been little previous research on self-harm among people of Chinese origin living in the UK, although this population has grown substantially in recent years and China is now the largest source of international students at UK universities.MethodsWe conducted a prospective cohort study using self-harm presentation data (1997–2011) collected from three hospitals in the City of Manchester, which has the largest Chinese population across all UK Local Authorities. Rate ratios between the Chinese and White groups were calculated using Poisson regression models. Chi-square tests (or Fisher’s exact tests), logistic regression, and log-binomial regression were used to examine differences in characteristics and clinical management between groups.ResultsEthnicity was known in the study cohort for 23,297 (87%) amongst 26,894 individuals aged 15 years and above. A total number of 97/23,297 (0.4%) people of Chinese ethnic origin presented with self-harm over the study period and 20,419 (88%) were White people. Incidence of self-harm in the Chinese group (aged 16–64 years) was less than one fifth of that found in White people (0.6 versus 3.2 per 1000 person-years; rate ratio 0.18, 95% confidence interval 0.13-0.24), and was particularly low amongst men of Chinese origin. Individuals of Chinese origin who presented with self-harm were younger, more likely to be female and students, and more likely to self-injure and describe relationship problems as a precipitant than White people. They were less likely to have clinical risk factors such as drug/alcohol misuse and receiving psychiatric treatment, and were rated to have lower risk of self-harm repetition by treating clinicians.ConclusionFuture research needs to investigate whether the low incidence of self-harm presenting to hospitals amongst people of Chinese origin truly reflects a lower frequency of self-harm, or alternatively is due to markedly different post-episode help-seeking behaviours or student overrepresentation in this ethnic group. Relevant healthcare professionals need to be aware of the risk characteristics of people of Chinese origin who self-harm.Electronic supplementary materialThe online version of this article (doi:10.1186/s12888-015-0467-0) contains supplementary material, which is available to authorized users.

Intentional self-harm in culturally and linguistically diverse communities: A study of hospital admissions in Victoria, Australia

“…Sudan is known to have high levels of existing mental illness due to civil conflict, and people from Sudan are known to be more likely to have entered Australia as refugees (Milner and Khawaja, 2010;Schweitzer et al, 2006). In contrast, the lower rate of selfharm in the Chinese population is consistent with patterns of self-harm in Chinese people in countries such as England (Chang et al, 2015). Unfortunately, we were unable to directly compare the rates of self-harm by CALD populations with the corresponding rates in their countries of origin, due to limited available evidence about hospital-admitted self-harm in the relevant birth countries.…”

Self-mutilation nursing diagnosis concept of analysis of the NANDA-I taxonomy

“…It would be necessary to conduct population studies in the Southern Hemisphere, in order to better understand the interaction between race and self-mutilation, and even among the socioeconomic factors of populations where there are hodgepodge of races and this population is characterized as majoritária. 45,46 By analyzing data on defining characteristics, one of the main findings of this research was the lack of specific descriptions of the acts that were being classified as self-mutilation. This pattern was repeated in 25% of published studies, hampering identification of the most common forms and also the sites in most common body in the practice of self-mutilation.…”

Ethnic differences in compulsory admissions for psychiatric disorders in the UK: a systematic review and meta-analysis

“…(10,11,14,18,27,33) Therefore, no conclusions can be drawn from a generalised grouping of all Asian patients, providing a possible direction for future investigations. (30) …”

“…(30,34) In addition, many studies have not categorised Asians into subgroups despite significant cultural differences within the racial group. (10,11,14,18,27,33) Therefore, no conclusions can be drawn from a generalised grouping of all Asian patients, providing a possible direction for future investigations.…”

“…Title Rating (Chang, Steeg, & Kapur, 2015) (30) Self-harm amongst people of Chinese origin vs White people living in England: a cohort study Moderate (Singh, Burns, Tyrer, & Islam, 2014) (10) Ethnicity as a predictor of detention under the Mental Health Act High (Corrigall & Bhugra, 2013) (14) The role of ethnicity and diagnosis in rates of adolescent psychiatric admission and compulsory detention: a longitudinal case-note study. …”