New research shows that just 700 people have been responsible for more than 13,000 hospital admissions relating to self-harm over the past decade.
A study of self-harm by the National Suicide Research Foundation to be published this week shows the extent of repeated self-injury is much greater than was previously thought to be the case.
Last year, for example, there were about 12,000 presentations to hospital as a result of self-harm. About one in five (21 per cent) of these cases involved a repeat act during the year.
But a new analysis of self-harm data between 2003 and 2012 shows that more than half (52 per cent) of cases of self-harm involved people who had previously deliberately injured themselves.
Risk factors
Those most at risk of repeatedly self-harming were found to be those with a history of previous self-injury, as well as those with psychiatric problems and personality disorders. Another risk factor was abuse of alcohol or drugs.
The risk of repetition within just three months was highest among those who had been admitted to a psychiatric ward and those who left before receiving a risk assessment and recommendation.
Prof Ella Arensman, director of research at the National Suicide Research Foundation, said the findings could prove vital in helping to identify those at most risk of self-harming again. "This is key information for doctors or nurses involved in assessing these patients," she said.
“Any patient who self- harms should have the appropriate assessment to determine their risk of self-harming again. But if a certain group of people is coming back many times over, there are reasons why we should enhance these assessments.”
Behaviour
Prof Arensman said she was encouraged that the
Health Service Executive
has prioritised actions addressing the needs of people who frequently engage in self-harm.
These include the national implementation of therapy designed to help people change patterns of behaviour such as self-injury, along with self-harm awareness training for all accident and emergency department staff in parts of the HSE.
Other measures that have the potential to support those at risk included the planned allocation of dozens of specialist self-harm assessment nurses to hospital staff, along with supporting development of national guidelines for the assessment and management of people who self-harm.
Separately, new research indicates that antidepressants have proved effective in tackling suicide.