Self-harm presentations among women 45% higher than for men, report finds

Rates of self-harm did not increase during the Covid-19 pandemic despite initial fears it would drive an increase in suicidal behaviour, according to a new report.

However, young women in the 15-19 year-old age group are self-harming at a rate more than four times the average for the general population, the 2021 report of the National Self-Harm Registry Ireland shows. The gap between self-harming rates for women and men is wider than ever.

A total of 12,661 self-harm presentations were made to hospitals by 9,533 people in 2021, according to the register, operated by the National Suicide Research Foundation. The rate of people presenting to hospital following self-harm was 196 per 100,000, similar to the rate of 200 per 100,000 reported in 2020.

Consistent with previous years, the highest rates of self-harm were recorded among young people. The peak rate for women was in the 15-19 years age group at 888 per 100,000. The peak rate for men was in the 20-24 years age group at 387 per 100,000.

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Since 2007, rates of self-harm have increased among young adolescents aged 10-14 years, but in particular for girls.

The finding that there was no increase in self-harm presentations in hospital during the second year of the pandemic runs contrary to early concerns and expectations of a rise in self-harm and suicidal behaviours during the pandemic and to commentary in the media, the report says.

The use of the registry is “fundamental to addressing misinformation, in particular during public health emergencies”.

“The finding of no increase in self-harm rates during the second year of the Covid-19 pandemic is reassuring,” said Dr Mary Joyce, manager of the registry. “This is similar to the findings from 2020 in the early stages of the pandemic.

“However, it will be important to continue to monitor and evaluate the incidence of suicide and self-harm in subsequent years and post-pandemic. The consequences of economic disruption on suicidal behaviour are of particular concern given existing evidence for increases in suicidal behaviour during economic recessionary times.”

In 2021, self-harm presentations among males were 17 per cent lower than in 2018 and 24 per cent lower than in 2010, before the economic recession. However, the rate of self-harming among women has remained stable for more than a decade. In 2021, it was 45 per cent higher than that for men, the largest difference seen in 20 years.

The 2021 report shows there were fewer presentations for self-harm during periods when Covid-19 restrictions were in place. On the first day of easing of level 5 restrictions in April, 50 presentations occurred, one of the highest daily numbers recorded.

As in previous years, intentional drug overdose was the most common method of self-harm, involved in almost two-thirds of presentations in 2021.

A quarter of presentations were accounted for by repetition. Of everyone who presented to hospital due to self-harm in 2021, 15.5 per cent made at least one repeat presentation during the year. Residents of homeless shelters and hostels, and people of no fixed above, accounted for 6.6 per cent of presentations.

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