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In 2013, self-harm cost hospitals in England an estimated £128.6m according to a new study led by the NDPH and the Centre for Suicide Research at Oxford University. 

The paper, published in Epidemiology and Psychiatric Sciences, provides the first detailed study of self-harm and associated hospital costs. The authors found that the number of people visiting hospital for self-harm injuries is 60% higher than previously estimated by Public Health England. 

Senior author, Professor Keith Hawton, Director of the Centre for Suicide Research said ‘Suicide affects people of all socioeconomic backgrounds and is the leading cause of death in males aged 10-49 years and females age 10-34 years in England and Wales. Approximately half of individuals who die by suicide have a history of self-harm, and hospital presentation for self-harm often occurs shortly before suicide. This highlights the need for primary and secondary prevention interventions that focus on reducing self-harm presentations and on provision of effective aftercare for those who do self-harm.’ 

The study authors estimated that 228,075 hospital visits in England by 159,857 patients (39% male and 61% female) in 2013 were a result of self-harm. Their definition included intentional self-poisoning and self-injury. They found that 30% of self-harm related hospital visits by men were by those aged between 40 and 49 and that 28% of hospital visits related to self-harm in women were by those aged 19 to 29. The incidence of self-harm was lower in coastal areas, higher inland, and highest in London. 

The research team used data collected as part of the Multicentre Study of Self-harm in England, which included individual data for patients presenting with self-harm at five emergency departments: one in Oxford, three in Manchester and one in Derby. Models and statistical analyses were used to estimate the incidence and cost of self-harm presentations to hospitals across Clinical Commissioning Groups (CCGs) in England by age and gender. 

Lead author, Dr Apostolos Tsiachristas, said ‘The results of this study may assist national and local health decision makers in planning the distribution of funds for self-harm and prioritising interventions in areas with the highest need for tackling self-harm. Providing the incidence of self-harm presentations in each CCG by gender and age highlights sub-populations potentially where additional resources might be targeted to help prevent self-harm and assist those who have self-harmed.’ 

The research approach, which includes measuring resource use and costs rather than relying on published health system charges, could be used in other countries to develop self-harm prevention strategies.