- Title
- Characteristics of self-harm presentations to the emergency department of the Royal Melbourne Hospital, 2012–2019: Data from the Self-Harm Monitoring System for Victoria
- Creator
- Witt, Katrina; Rajaram, Gowri; Lamblin, Michelle; Knott, Jonathan; Dean, Angela; Spittal, Matthw J.; Carter, Greg; Page, Andrew; Pirkis, Jane; Robinson, Jo
- Relation
- Australasian Emergency Care Vol. 26, Issue 3, p. 230-238
- Publisher Link
- http://dx.doi.org/10.1016/j.auec.2023.01.003
- Publisher
- Elsevier
- Resource Type
- journal article
- Date
- 2023
- Description
- Background: Rates of self-harm and suicide are increasing world-wide, particularly in young females. Emergency departments (EDs) are a common first point-of-contact for young people who self-harm. We examined age- and sex-related differences in: (1) rates of self-harm over an eight-year period; (2) changes in demographic, presentation, and treatment characteristics over this period, and; (3) rates of, and time to, self-harm re-presentation. Methods: This was a retrospective observational study of all self-harm presentations in persons aged nine years and older to the Royal Melbourne Hospital ED over an eight-year period, 1 January 2012–31 December 2019. The Royal Melbourne Hospital is one of the largest and busiest public EDs in Melbourne, Australia and serves a primary catchment area of approximately 1.5 million people. Results: There were 551,692 presentations to the Royal Melbourne Hospital ED over this period (57.6 % by females). Of these, 7736 (1.4 %) were self-harm related. These self-harm presentations involved 5428 individuals (54.8 % female), giving an overall repetition event-rate of 11.2 %. Self-harm related presentations increased by 5 % per year (Incidence Rate Ratio [IRR 1.05, 95 % CI 1.02–1.08); a 44 % increase over the eight-year period (IRR 1.44, 95 % CI 1.15–1.80). This increase was more pronounced for young people aged< 25 years. The most common method was self-poisoning, primarily by anxiolytics or analgesics. The proportion of presentations involving self-poisoning alone declined modestly over time, whilst the proportion involving self-injury alone increased. For just over half of all presentations the person was seen by ED mental health staff. The median time to first re-presentation was 4.5 months (Inter-Quartile Range [IQR] 0.7–13.2 months). Conclusions: Rates of hospital presenting self-harm may be increasing, particularly amongst young people, whilst most self-harm presentations occurred outside office hours; so appropriate ED staffing, training and clinical care models are needed. Around half of those with a repeat episode of self-harm repeated within three months of their index (i.e., first recorded) presentation. Efforts to establish appropriate aftercare services, including alternatives to ED services with service availability 24 h a day 7 days a week, aimed at reducing repetition rates, should be prioritised.
- Subject
- suicide; suicide attempt; self-harm, self-injury; emergency medicine; hospitals; adolescent; SDG 3; Sustainable Development Goals
- Identifier
- http://hdl.handle.net/1959.13/1494322
- Identifier
- uon:53771
- Identifier
- ISSN:2588-994X
- Language
- eng
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