Self-harm: Girls in Wales more likely to end up in hospital than boys

Girls in Wales are much more likely to end up in hospital after self-harming than boys according to new research led by Swansea University.

The study, the first of its kind, has been published in the Archives of Disease in Childhood and reveals this gender disparity is particularly evident among 10 to 15-year-olds who have self- harmed.

Most analyses of self-harm among young people have been restricted to hospital admissions or primary care data.

But this research, led by Professor Ann John of Swansea University Medical School, captured the full spectrum of those accessing healthcare and looked at data from GPs, emergency care departments and outpatient clinics, as well as hospital admissions for the years 2003 to 2015 inclusive in Wales, by using the Adolescent Mental Health Data Platform, a research platform created by Professor Ann John to enable child and adolescent mental health research and the SAIL Databank a data repository dedicated to providing a safe and trusted means of harnessing population-scaled data by using SAIL Databank.

The study included 937,697 young people, aged between 10 and 24, of whom 15,739 accessed healthcare services for self-harm.

Their findings showed:

  • Young people from deprived areas were most at risk - self-harm rates were more than double those in areas of least deprivation;
  • Although most youngsters accessed primary care services, the number of young people attending emergency care and subsequently being admitted to hospital did increase;

  • Rates of self-harm were highest among 15 to 19-year-olds, but from 2011 the largest increases were seen among 10 to 14-year -olds, particularly girls;

  • Hospital admissions for this younger age group almost doubled among boys and young men, and more than doubled among girls and young women;

  • However boys who attended emergency care after harming themselves were much less likely to be admitted to hospital than girls - a pattern the researchers branded "a cause for concern"; and,

  • More than half (58%) of those seeking emergency care for self-harm were boys and young men.

The gender disparity was most evident among 10 to 15-year-olds. Three quarters (76%) of girls in this age group were admitted to hospital compared with only around half of the boys (49%) but girls who had poisoned themselves were significantly more likely to be admitted (90%) than boys (69%) of the same age group.

Professor John, who is also Chair of the National Advisory Group to Welsh Government on Suicide and Self-harm Prevention, said:

Our findings highlight the opportunities for early intervention when young people attend or are brought into contact with health services for self-harm, especially in primary care and emergency departments.

There are initiatives to improve help-seeking in boys and young men but we also need to consider if, when they do attend, we manage them differently to girls and young women.

The researchers emphasised that this observational study cannot establish causes and only reflects contacts made with healthcare services rather than actual numbers of young people who self-harm in the community.

But they suggest that given that the data is based on a large sample of the population over a period of 12 years, the results are likely to be applicable to the rest of the UK.

Last month Welsh Government issued guidance to all schools in Wales regarding self-harm in young people which was developed by Professor John and colleagues following a workshop which included discussions of the study's findings.

Source:
Journal reference:

Marchant, A. et al. (2019) Self-harm presentation across healthcare settings by sex in young people: an e-cohort study using routinely collected linked healthcare data in Wales, UK. Archives of Disease in Childhood. doi.org/10.1136/archdischild-2019-317248

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