title: Impact of the recent recession on self-harm: Longitudinal ecological and patient-level investigation from the Multicentre Study of Self-harm in England.
abstract: BACKGROUND
  Economic recessions are associated with increases in suicide rates but there is little information for non-fatal self-harm.
  
  
  OBJECTIVE
  To investigate the impact of the recent recession on rates of self-harm in England and problems faced by patients who self-harm.
  
  
  METHODS
  Analysis of data from the Multicentre Study of Self-harm in England for 2001-2010 and local employment statistics for Oxford, Manchester and Derby, including interrupted time series analyses to estimate the effect of the recession on rates of self-harm.
  
  
  RESULTS
  Rates of self-harm increased in both genders in Derby and in males in Manchester in 2008-2010, but not in either gender in Oxford, results which largely followed changes in general population unemployment. More patients who self-harm were unemployed in 2008-10 compared to before the recession. The proportion in receipt of sickness or disability allowances decreased. More patients of both genders had employment and financial problems in 2008-2010 and more females also had housing problems, changes which were also largely found in employed patients.
  
  
  CONCLUSIONS
  We have assumed that the recession began in 2008 and information on problems was only available for patients having a psychosocial assessment.
  
  
  CONCLUSIONS
  Increased rates of self-harm were found in areas where there were greater rises in rates of unemployment. Work, financial and housing problems increased in people who self-harmed. Changes in welfare benefits may have contributed.
  
  
  BACKGROUND
  None.
authors.affiliation: Centre for Suicide Research, University Department of Psychiatry, Warneford Hospital, Oxford, UK. Electronic address: keith.hawton@psych.ox.ac.uk.
authors.forename: Keith
authors.initials: K
authors.lastname: Hawton
authors.affiliation: Centre for Suicide Research, University Department of Psychiatry, Warneford Hospital, Oxford, UK.
authors.forename: Helen
authors.initials: H
authors.lastname: Bergen
authors.affiliation: Centre for Suicide Research, University Department of Psychiatry, Warneford Hospital, Oxford, UK.
authors.forename: Galit
authors.initials: G
authors.lastname: Geulayov
authors.affiliation: Derbyshire Healthcare NHS Foundation Trust, Royal Derby Hospital, Derby, UK.
authors.forename: Keith
authors.initials: K
authors.lastname: Waters
authors.affiliation: Derbyshire Healthcare NHS Foundation Trust, Royal Derby Hospital, Derby, UK.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Ness
authors.affiliation: Centre for Suicide Prevention, Centre for Mental Health and Risk, University of Manchester, Oxford Road, Manchester, UK.
authors.forename: Jayne
authors.initials: J
authors.lastname: Cooper
authors.affiliation: Centre for Suicide Prevention, Centre for Mental Health and Risk, University of Manchester, Oxford Road, Manchester, UK.
authors.forename: Navneet
authors.initials: N
authors.lastname: Kapur
mesh_terms: D000328:Adult; D057172:Economic Recession; D004651:Employment / Q000706:statistics & numerical data; D004739:England / Q000453:epidemiology; D005260:Female; D006798:Housing; D006801:Humans; D007182:Income; D065186:Interrupted Time Series Analysis; D008297:Male; D008875:Middle Aged; D016728:Self-Injurious Behavior / Q000453:epidemiology* / Q000523:psychology; D013405:Suicide / Q000706:statistics & numerical data; D014478:Unemployment / Q000523:psychology*
keywords: Life problems; Recession; Self-harm; Unemployment; Welfare benefits