title: Young people who self-harm: a prospective 1-year follow-up study.
abstract: OBJECTIVE
  To explore repetition, service provision and service engagement following presentation of young people to emergency services with self-harm.
  
  
  METHODS
  969 patients who presented to accident and emergency services after self-harm were followed up prospectively for a period of 1 year. Data on rates, method, clinical history, initial service provision, engagement and repetition (defined as re-presenting to emergency services with further self-harm) were gathered from comprehensive electronic records.
  
  
  RESULTS
  Young people were less likely to repeat self-harm compared to those aged 25 and above. A psychiatric history and a history of childhood trauma were significant predictors of repetition. Young people were more likely to receive self-help as their initial service provision, and less likely to receive acute psychiatric care or a hospital admission. There were no differences in engagement with services between young people and those aged 25 and above.
  
  
  CONCLUSIONS
  Younger individuals may be less vulnerable to repetition, and are less likely to represent to services with repeated self-harm. All young people who present with self-harm should be screened for mental illness and asked about childhood trauma. Whilst young people are less likely to be referred to psychiatric services, they do attend when referred. This may indicate missed opportunity for intervention.
authors.affiliation: College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
authors.forename: Madiha
authors.initials: M
authors.lastname: Majid
authors.affiliation: College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
authors.forename: Maria
authors.initials: M
authors.lastname: Tadros
authors.affiliation: Birmingham and Solihull Mental Health Foundation Trust, Birmingham, UK.
authors.forename: George
authors.initials: G
authors.lastname: Tadros
authors.affiliation: Birmingham and Solihull Mental Health Foundation Trust, Birmingham, UK.|Warwick University, Coventry, UK.
authors.forename: Swaran
authors.initials: S
authors.lastname: Singh
authors.affiliation: Department of Psychiatry, University of Oxford, Oxford, UK.|Oxford Health NHS Foundation Trust, Oxford, UK.
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Broome
authors.affiliation: College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK. r.upthegrove@bham.ac.uk.|Birmingham and Solihull Mental Health Foundation Trust, Birmingham, UK. r.upthegrove@bham.ac.uk.
authors.forename: Rachel
authors.initials: R
authors.lastname: Upthegrove
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D057286:Electronic Health Records; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011446:Prospective Studies; D016728:Self-Injurious Behavior / Q000453:epidemiology* / Q000628:therapy*; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult
keywords: Engagement; Repetition; Self-harm; Service provision; Young people