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Multicenter Study
. 2022 Dec 1:318:238-245.
doi: 10.1016/j.jad.2022.08.106. Epub 2022 Aug 31.

Socio-economic disparities in patients who present to hospital for self-harm: patients' characteristics and problems in the Multicentre Study of Self-harm in England

Galit Geulayov  1 , Deborah Casey  2 , Elizabeth Bale  2 , Fiona Brand  2 , Caroline Clements  3 , Bushra Farooq  3 , Nav Kapur  4 , Jennifer Ness  5 , Keith Waters  5 , Anita Patel  5 , Keith Hawton  6
Affiliations
Multicenter Study

Socio-economic disparities in patients who present to hospital for self-harm: patients' characteristics and problems in the Multicentre Study of Self-harm in England

Galit Geulayov et al. J Affect Disord. .

Abstract

Background: We examined disparities in sociodemographic and clinical characteristics and in problems preceding self-harm across levels of socio-economic deprivation (SED) in persons who presented to hospital for self-harm.

Method: 108,092 presentations to hospitals (by 57,306 individuals) following self-harm in the Multicentre Study of Self-harm in England (1/1/2000-31/12/2016). Information on area-level SED was based on the English Index of Multiple Deprivation. Information about patients' characteristics and problems was obtained from self-harm monitoring systems in the hospitals. We assessed the association of SED with the characteristics of interest using descriptive statistics.

Results: Overall, 45 % of the presentations were by individuals from areas ranked nationally as most deprived, while 13 % of episodes were by individuals from the least deprived areas. Males and non-white ethnic groups were over-represented in the most deprived SED stratum. Previous self-harm was more prevalent in the two most deprived groups. Relationships difficulties with partners and other family members were reported more commonly by individuals from less socio-economically deprived areas, as were problems pertaining to finances and employment or studies. Problems in relationships with friends were more prevalent in the most deprived group relative to other groups.

Limitations: Information about problems which preceded self-harm was available only for patients who received psychosocial assessment.

Conclusions: Patients vary considerably across area-level SED strata in terms of gender, ethnicity, and the problems which preceded their self-harm. These findings emphasise the need to use an individualised approach to patients in understanding the unique circumstances which contribute to their self-harm and their specific care needs.

Keywords: Self-harm; Socio-economic deprivation; Socio-economic disparities; Suicide.

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Conflict of interest statement

Conflict of interest KH declare grants from the National Institute for Health Research and the Department of Health and Social Care. He is a member of the National Suicide Prevention Strategy for England Advisory Group. KH is a National Institute for Health Research (NIHR) Senior Investigator (Emeritus). NK is a member of the Department of Health's National Suicide Prevention Advisory Group. NK chaired the NICE guideline development group for the longer-term management of self-harm and is currently Topic Advisor for the new NICE self-harm guideline. He also chairs the NICE guideline committee for depression in adults. All other authors declare no competing interests. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health and Social Care.

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