INFORMATION RESOURCES ON MENTAL HEALTH AND WELL-BEING
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Self-harm
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Prevalence of self-harm
Self-harm is an expression of acute psychological distress and it is often, though not always, associated with a variety of psychiatric disorders. Self-harm occurs in all sections of the population but is more common among people who are disadvantaged in socio-economic terms and among those who are single or divorced, live alone, are single parents or have a severe lack of social support.
Since many acts of self-harm do not come to the attention of healthcare services, hospital attendance rates do not reflect the true scale of the problem.
Information on self-harm is available from the Survey of Psychiatric Morbidity among Adults Living in Private Households, and the associated report Non-fatal Suicidal Behaviour among Adults aged 16 to 74 in Great Britain. This research describes the prevalence (past week, past year and lifetime) of suicidal thoughts, suicidal attempts and deliberate self-harm by socio-demographic, socio-economic, psychiatric and social functioning characteristics of the survey respondents.
The analysis suggests that in Great Britain between 4.6% and 6.6% of people have self harmed. However, even this might be an underestimate. Self-harm can occur at any age but it more common in adolescence and young adulthood. Overall, women are more likely to self-harm than men and this is most pronounced in adolescence where girls may be more than three times more likely to self-harm than boys.
Within the East Midlands, the Mental Health Liaison Team in Derby have analysed data on 1955 episodes of self-harm presenting to Derby Hospitals in 2005. Their report (below) looks at patterns of presentation by age, gender, socio-economic status, previous history and method of self harm as well as patterns of onward referral. The Team use this information as part of a regular audit cycle informing the ongoing development of their service.
The Mental Health Liaison Team in Derby regularly undertake "suicide audits" of cases in their Southern Derbyshire catchment area to inform local prevention strategy. The three reports below provide examples of this work. The first report is wide ranging descriptive analysis of cases while the second and third reports focus in greater detail on location of suicide and financial problems as a predisposing factor.
NICE Guideline on the Management and Prevention of Self-harm
NICE and the National Collaborating Centre for Mental Health have published a guideline for the NHS in England and Wales on the short-term treatment and management of self harm. This guidance covers:
- the care people who harm themselves can expect to receive from healthcare professionals in hospital and out of hospital
- the information they can expect to receive
- what they can expect from treatment
- what kinds of services best help people who harm themselves
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