More than 20 people per day presenting at hospitals after self-harm
People, 2020 That Occasion Hospital Is Most Harm With Young Among One The Than Prevalent Report Many Shows Self For File More Attending On Picture
The number of people presenting to hospitals having self-harmed in the first half of last year fell slightly compared to pre-pandemic levels - but with considerable monthly variations.
Data collected from hospitals by the National Self-Harm Registry, found that the rate of presentation between January and June last year was 21 per day. That compares with rate of 21.2 per day for the same months in 2018 and 2019.
According to the National Suicide Research Foundation (NSRF), which operates the registry: "While there was no overall difference in hospital-presenting self-harm between January-June 2021 and the same period of 2018-2019, there were marked differences in specific months, namely fewer self-harm presentations than expected in January 2021 and to a lesser extent in May 2021 and more presentations than expected in April 2021."
The monthly breakdown showed that presentations in March, April and June last year were higher than the equivalent months in 2018 and 2019, and lower in January, February and May. The peak month was April, with 734 presentations across the 22 hospitals.
"The rate increased across the four months of lockdown and in April 2021, the rate was 45% higher than in January and 16% higher than in April 2018-2019," it said.
"Coinciding with the easing of restrictions in May, the self-harm rate fell by 19%, a reduction that meant the rate in May 2021 was 11% lower than in May 2018-2019."
The briefing report noted various developments across the period, from the unrestricted Christmas of 2020 to increased vaccination uptake and the return to school in Spring 2021.
"Following an unrestricted Christmas holiday period with large numbers of visitors from the UK, Ireland experienced its third and largest wave of Covid-19 in early 2021, even achieving the highest seven-day infection rate in the world in mid-January," it said.
The registry recorded a total of 3,792 self-harm presentations to the 22 hospitals during January-June 2021, but the NSRF stressed the data was provisional and subject to change.
Meanwhile, the data also shows that there was no increase in self-harm rates in the early stages of the Covid-19 pandemic.
The report for 2020 shows that self-harm is most prevalent among young people, with many attending hospital on more than one occasion.
The 2020 report shows there were 12,553 self-harm presentations by 9,550 individuals - a presentation rate 3% lower than that in 2019 and 10% lower than in the peak year of 2010.
Dr Paul Corcoran, Head of Research at the NSRF, said the report was delayed by a year because of the pandemic. Lockdown periods in March, April and December 2020 saw the fewest monthly presentations.
The data found that self-harm leading to a hospital presentation was more prevalent among females than among males, with 224 per 100,000 for women and 176 per 100,000 for men. However, while the male presentation rate fell by 6% in 2020, the comparable rate for females dropped by just 1%.
The peak rate for females was in the 15-19 years age group, implying that one in every 128 girls in the age group had self-harmed. The peak rate for males in 2020 was in 25- to 29-year-olds.
One group in which there was an increase overall in self-harm presentations in 2020 was the homeless. There were 899 presentations made by residents of homeless hostels and people of no fixed abode in 2020, accounting for approximately 7.5% of all presentations recorded, up from 5.4% in 2019.
Overall, intentional drug overdose was present in 62% of hospital presentations for self-harm in 2020 while alcohol was present in a third of cases.
For 68% of presentations, the patient was assessed by a member of the mental health team in the presenting hospital and 49% were discharged, with 80% provided with a recommended referral or follow-up appointment. However, in 11% of presentations, the individual left the ED before a next care recommendation could be made.
According to the report:
It compared levels of discharge and recommended in-patient care and said differences were "likely to be due to variation in the availability of resources and services, but it also indicates that assessment and management procedures for self-harm patients are likely to vary across the country."
The report also flagged the issues surrounding those who repeatedly self-harm.
"Of the 9,063 self-harm patients who presented to hospital in 2020, 1,421 (15.7%) made at least one repeat presentation to hospital during the calendar year," it said. "Therefore, repetition continues to pose a major challenge to hospital staff and family members involved. In 2020, at least five self-harm presentations were made by 144 individuals. These patients account for 1.6% of all self-harm patients."
Recommendations included improved assessment in hospitals, contacting relatives, programmes addressing the issue in schools at both primary and secondary level, and restricting access to means of self-harm, including over-the-counter medicines.
- If you are affected by any of the issues raised in this article, please click here for a list of support services.