Self-harm rates, clinical contact and risks of suicide and early death before, during and after the COVID-19 peak: cohort study of linked health data

Lead Research Organisation: University of Manchester
Department Name: School of Health Sciences

Abstract

The COVID-19 pandemic could have a profound impact on suicide. People who have self-harmed, for example by intentionally poisoning or injuring themselves, have particularly high risks of suicide. Therefore, it is important to understand how the pandemic has affected rates of self-harm. So far, information has come from people who have chosen to respond to surveys, rather than from the general population. We aim to find out:

- how the pandemic has affected rates of self-harm
- likelihood of being prescribed medication for mental illness and being referred for mental health treatment by GPs for patients who have self-harmed
- risks of further self-harm and suicide

The pandemic has affected people differently so we will examine differences by age group, gender, ethnic group, existing mental or physical illness and social deprivation. This research will use anonymous health records, linked to information on deaths, for around 11 million patients in England. The study will cover the periods before, during and after the peak of the pandemic, including up to August 2020.

The findings will be shared rapidly, with key messages communicated on the study's blog. The research team will also host a webinar to share and discuss findings with local and national suicide prevention team and health services.

Technical Summary

Incidence of self-harm and suicide could increase substantially following the COVID-19 pandemic and subsequent economic downturn. People who have intentionally poisoned or injured themselves have greatly elevated risks of suicide and other causes of premature death. Certain groups are particularly vulnerable, including people of lower socioeconomic position, those with existing health problems and young people.

This proposed research will use nationally-representative, linked, anonymised healthcare data for around 11 million current patients in England as recorded in the Clinical Practice Research Datalink (CPRD). We will examine self-harm incidence rates, subsequent contact with general practice and mental health services, and risks for self-harm repetition and death by suicide and other external causes. The study will cover the periods before, during and after the pandemic's peak, including up to August 2020. Differences by age group, gender, ethnic group, COVID-19 shielding status, mental illness and area-level social deprivation will be examined.

The findings will provide timely and essential evidence for informing suicide prevention strategies, for which people who have already harmed themselves non-fatally are a key focus. This study will provide nationally representative evidence to inform how the pandemic has affected suicidal behaviour and access to clinical services and which groups are at highest risk. The findings will be disseminated rapidly, with key messages communicated openly via the study's blog prior to full academic publication. The investigative team will also host a webinar to share and discuss salient findings with local and national suicide prevention teams, health service commissioners and clinicians.

Publications

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Description The Conversation article 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact An article published in The Conversation with the title 'Fewer people sought help for mental illness during the UK's first lockdown - new research' which had received over 4,000 readers as of 2nd March 2021.
Year(s) Of Engagement Activity 2021
URL https://theconversation.com/fewer-people-sought-help-for-mental-illness-during-the-uks-first-lockdow...