title: Self-harm in the UK: differences between South Asians and Whites in rates, characteristics, provision of service and repetition.
abstract: BACKGROUND
  Rates of self-harm appear high in South Asian young women in the United Kingdom (UK) although previous studies were mostly small. Data on treatment and outcomes for South Asians are lacking. This study compared rates of self-harm, socio-demographic and clinical characteristics, provision of services and risk of repetition by ethnicity.
  
  
  METHODS
  A prospective cohort of adult self-harm attendees (n = 7185), aged 15 and over presenting to four emergency departments in the cities of Manchester and Salford, UK over a 4-year period.
  
  
  RESULTS
  The study included 299 South Asians. South Asian women aged 16-24 years were more likely to self-harm than Whites of the same age group (1010.9 vs. 754 per 100,000). Across all age groups the rates of self-harm were lower in South Asian men compared to White men and to South Asian women. South Asian women were significantly more likely to report relationship problems within the family than White women (32% vs. 19%, P = <0.001). South Asians were less likely than Whites to report depressive symptoms and to be offered specialist mental health services (Rate ratio = 0.75), and more likely to be referred back to the GP (Rate ratio = 1.83). South Asians were less likely to attend with a repeat episode (Rate ratio = 0.56).
  
  
  CONCLUSIONS
  Young South Asian women are at high risk of self-harm, but their clinical risk appears to be lower in terms of the accepted contextual factors contributing to risk. Potentially useful service provision may include an interpersonal problem solving approach although to be effective, interventions would need to be acceptable to South Asian women and culturally appropriate.
authors.affiliation: Centre for Suicide Prevention, Division of Psychiatry, 7th Floor Williamson Building, University of Manchester, Oxford Road, Manchester M13 9PL, UK. jayne.cooper@manchester.ac.uk
authors.forename: Jayne
authors.initials: J
authors.lastname: Cooper
authors.forename: Nusrat
authors.initials: N
authors.lastname: Husain
authors.forename: Roger
authors.initials: R
authors.lastname: Webb
authors.forename: Waquas
authors.initials: W
authors.lastname: Waheed
authors.forename: Navneet
authors.initials: N
authors.lastname: Kapur
authors.forename: Else
authors.initials: E
authors.lastname: Guthrie
authors.forename: Louis
authors.initials: L
authors.lastname: Appleby
mesh_terms: D000293:Adolescent; D000328:Adult; D001208:Asia / Q000208:ethnology; D044466:Asian People; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D010552:Personality Assessment; D016728:Self-Injurious Behavior / Q000453:epidemiology*; D044465:White People