Self-harm in England: a tale of three cities

Hawton, Keith; Bergen, Helen A.; Casey, Deborah; Simkin, Sue; Palmer, Ben; Cooper, Jayne; Kapur, Nav; Horrocks, Judith; House, Allan; Lilley, Rachael; Noble, Rachael; Owens, David

doi:10.1007/s00127-007-0199-7

Cited by 338 publications

(292 citation statements)

References 27 publications

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“…However, there is a clear pattern to the time of presentation [3,15]. In this study 70.8% of selfpoisoning episodes presented outside working hours of 09.00 h to 17.00 h compared with 73-80% in published literature [3,15]. This has clear implications for designing safe and efficient care pathways for these patients.…”

Section: Figurementioning

confidence: 71%

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Detailed analyses of self‐poisoning episodes presenting to a large regional teaching hospital in the UK

Prescott

Stratton

Freyer

et al. 2009

Brit J Clinical Pharma

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WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT• Deliberate self-poisoning accounts for 170 000 presentations to UK hospitals each year with a profound impact on the health of individual patients. We have basic demographic information on self-poisoning but there is a relative paucity of contemporary, detailed information on the patterns of presentation, drugs taken in overdose and the current impact on services. WHAT THIS STUDY ADDS• This study provides detailed analyses of demographics, timing of presentation, patterns of overdose, drugs taken with special emphasis on paracetamol, the patient pathway through hospital and an estimation of the financial impact to the hospital of this patient group. This information is essential in planning the necessary service developments in emergency departments and medical admissions units that are required to optimize management of this patient group. AIMSThe primary aim of this paper is to provide comprehensive contemporaneous data on the demographics, patterns of presentation and management of all episodes of deliberate self-poisoning presenting to a large regional teaching hospital over a 12 month period. METHODSWe undertook detailed, retrospective analyses using information from electronic patient records and local patient-tracking, pathology and administrative databases. Statistical analyses were performed using Chi-squared tests, ANOVA and two-tailed t-tests (Graphpad Prism). RESULTSOne thousand five hundred and ninety-eight episodes of deliberate self-poisoning presented over the year. Demographic data and information on the month, day and time of admission are provided. 70.7% presented to the emergency department (ED) within 4 h of ingestion. 76.3% of patients had only one episode in an extended 29 month follow-up period. A mean of 1.72 drugs were taken per episode with just over half of all episodes involving a single drug only. Paracetamol and ibuprofen were the two most commonly ingested drugs involved in 42.5% and 17.3% of all overdoses respectively. 56.3% of patients taking paracetamol reported ingesting over 8 g (one over the counter packet). Detailed mapping of the patients' pathway through the hospital allowed an estimation of the hospital cost of caring for this patient group at £1.6 million pounds per year. CONCLUSIONSWe present comprehensive and contemporary data on presentations to hospital resulting from deliberate self-poisoning. We include demographic information, presentation patterns, drugs used, a detailed analysis of episodes involving paracetamol and an estimate of the financial burden to hospitals of overdose presentations.

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Section: Figurementioning

confidence: 71%

“…One thousand one hundred and eighty of the 4740 suicides (24.9%) were attributable to 'deliberate self harm' (DSH) [1]. Self-poisoning accounts for 85-94% of cases of DSH and a higher proportion of fatal events; it is therefore a major contributor to deaths from suicide [3,4].…”

Section: Introductionmentioning

confidence: 99%

Detailed analyses of self‐poisoning episodes presenting to a large regional teaching hospital in the UK

Prescott

Stratton

Freyer

et al. 2009

Brit J Clinical Pharma

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“…While this intervention is not suitable for all patients who engage in self-harm, it should be available in services for this patient population. 2 DBT can reduce the frequency of self-harm in patients with borderline personality disorder who engage in repeated acts of self-harm. The usual format for DBT is quite lengthy (one year) and includes both individual and group-based approaches.…”

Section: Implications For Practicementioning

confidence: 98%

“…In the UK it is estimated that there are now more than 200,000 presentations to general hospitals each year. 2 Self-harm consumes considerable hospital resources in both developed 3 and developing 4 countries. Self-harm is most common in younger people.…”

Section: Introductionmentioning

confidence: 99%

Psychosocial interventions following self-harm in adults: a systematic review and meta-analysis

Hawton

Witt

Salisbury

et al. 2016

The Lancet Psychiatry

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“…This search resulted in scrutiny of many cases where the presenting problem did not indicate self-harm but, by this method, led to inclusion of cases of self-harm in which there was no referral for a psychosocial assessment cases often missed in published self-harm research. Identifying self-harm episodes using this system is of proven reliability (Sellar et al, 1990) and its use in our study is described in more detail elsewhere (Horrocks et al, 2004;Hawton et al, 2007). The monitoring of self-harm episodes and later collection of mortality data (see below) was approved by the Local Research Ethical Committee.…”

Section: Data Collection and Analysismentioning

confidence: 99%

Combination of self-harm methods and fatal and non-fatal repetition: A cohort study

Birtwistle

Kelley

House

et al. 2017

Journal of Affective Disorders

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Self-harm in England: a tale of three cities

Cited by 338 publications

References 27 publications

Detailed analyses of self‐poisoning episodes presenting to a large regional teaching hospital in the UK

Detailed analyses of self‐poisoning episodes presenting to a large regional teaching hospital in the UK

Psychosocial interventions following self-harm in adults: a systematic review and meta-analysis

Combination of self-harm methods and fatal and non-fatal repetition: A cohort study

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