Self-harm and life problems: findings from the Multicentre Study of Self-harm in England.
OBJECTIVE
Self-harm is a major clinical problem and is strongly linked to suicide. It is important to understand the problems faced by those who self-harm to design effective clinical services and suicide prevention strategies. We investigated the life problems experienced by patients presenting to general hospitals for self-harm.


METHODS
Data for 2000-2010 from the Multicentre Study of Self-harm in England were used to investigate life problems associated with self-harm and their relationship to patient and clinical characteristics, including age, gender, repeat self-harm and employment status.


RESULTS
Of 24,598 patients (36,431 assessed episodes), 57% were female and with a mean age of 33.1 years (SD 14.0 years), 92.6% were identified as having at least one contributing life problem. The most frequently reported problems at first episode of self-harm within the study period were relationship difficulties (especially with partners). Mental health issues and problems with alcohol were also very common (especially in those aged 35-54 years, and those who repeated self-harm). Those who repeated self-harm were more likely to report problems with housing, mental health and dealing with the consequences of abuse.


CONCLUSIONS
Self-harm usually occurs in the context of multiple life problems. Clinical services for self-harm patients should have access to appropriate care for provision of help for relationship difficulties and problems concerning alcohol and mental health issues. Individualised clinical support (e.g. psychological therapy, interventions for alcohol problems and relationship counselling) for self-harm patients facing these life problems may play a crucial role in suicide prevention.
Self-Harm Research Group, School of Psychology, University of Nottingham, University Park, Nottingham, NG72RD, UK. Ellen.Townsend@nottingham.ac.uk.
Ellen
E
Townsend
Centre for Self-Harm and Suicide Prevention Research, Research and Development Centre, Derbyshire Healthcare NHS Foundation Trust, Kingsway, Derby, DE22 3LZ, UK.
Jennifer
J
Ness
Centre for Self-Harm and Suicide Prevention Research, Research and Development Centre, Derbyshire Healthcare NHS Foundation Trust, Kingsway, Derby, DE22 3LZ, UK.
Keith
K
Waters
Centre for Suicide Prevention, University of Manchester, Centre for Mental Health and Safety, Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, UK.
Navneet
N
Kapur
Centre for Suicide Prevention, University of Manchester, Centre for Mental Health and Safety, Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, UK.
Pauline
P
Turnbull
Centre for Suicide Prevention, University of Manchester, Centre for Mental Health and Safety, Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, UK.
Jayne
J
Cooper
Centre for Suicide Research, University Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX, UK.
Helen
H
Bergen
Centre for Suicide Research, University Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX, UK.
Keith
K
Hawton
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000437:Alcoholism / Q000453:epidemiology; D004651:Employment / Q000706:statistics & numerical data; D004739:England / Q000453:epidemiology; D005260:Female; D006798:Housing / Q000706:statistics & numerical data; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology; D008875:Middle Aged; D000066550:Physical Abuse / Q000523:psychology; D012307:Risk Factors; D016728:Self-Injurious Behavior / Q000453:epidemiology* / Q000523:psychology*; D055815:Young Adult; D000092864:Suicide Prevention
Age; Gender; Life problems; Repetition; Self-harm