Hospital care and repetition following self-harm: multicentre comparison of self-poisoning and self-injury.
BACKGROUND
Quantitative research about self-harm largely deals with self-poisoning, despite the high incidence of self-injury.


OBJECTIVE
We compared patterns of hospital care and repetition associated with self-poisoning and self-injury.


METHODS
Demographic and clinical data were collected in a multicentre, prospective cohort study, involving 10,498 consecutive episodes of self-harm at six English teaching hospitals.


RESULTS
Compared with those who self-poisoned, people who cut themselves were more likely to have self-harmed previously and to have received support from mental health services, but they were far less likely to be admitted to the general hospital or receive a psychosocial assessment. Although only 17% of people repeated self-harm during the 18 months of study, survival analysis that takes account of all episodes revealed a repetition rate of 33% in the year following an episode: 47% after episodes of self-cutting and 31% after self-poisoning (P<0.001). Of those who repeated, a third switched method of self-harm.


CONCLUSIONS
Hospital services offer less to people who have cut themselves, although they are far more likely to repeat, than to those who have self-poisoned. Attendance at hospital should result in psychosocial assessment of needs regardless of method of self-harm.
Academic Unit of Psychiatry and Behavioural Sciences, Leeds Institute of Health Sciences, University of Leeds, Charles Thackrah Building, 101 Clarendon Road, Woodhouse, Leeds LS2 9LJ.
Rachael
R
Lilley
David
D
Owens
Judith
J
Horrocks
Allan
A
House
Rachael
R
Noble
Helen
H
Bergen
Keith
K
Hawton
Deborah
D
Casey
Sue
S
Simkin
Elizabeth
E
Murphy
Jayne
J
Cooper
Navneet
N
Kapur
D000328:Adult; D000359:Aftercare / Q000379:methods / Q000706:statistics & numerical data*; D062787:Drug Overdose; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D004739:England / Q000453:epidemiology; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment / Q000592:standards; D011041:Poisoning / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy; D012008:Recurrence; D016728:Self-Injurious Behavior / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy; D013997:Time Factors