Abstract
BackgroundMany self-harmers do not present in hospitals due to the self-harm. It is still unclear on the differences between medically treated and untreated self-harm in China. This study described the differences of the two groups of self-harmers using the largest psychological aid hotline data.MethodsThe present observational study recruited 3,403 hotline callers who reported episodes of self-harm before the call. In routine assessment, information about the most recent episode of self-harm was collected, including the method of self-harm, the wish to die, goals of the self-harm, and any medical treatment (irrespective of psychological services) in the hospital. The callers were divided into two groups: those who received hospital-based medical treatment due to the most recent self-harm (treated self-harm callers) and those who did not (untreated self-harm callers).ResultsIn the most recent episode of self-harm, 65% (n = 2,217) of callers were untreated and 55% (1,226/2,217) of the untreated self-harm callers reported a wish to die. A total of 67% of the callers reported that their main goal of self-harm was to relieve suffering. The most common self-harm methods were using instruments (knife or rope) and overdosing on medicines. Compared with treated self-harm callers, the untreated self-harm callers were less likely to have a wish to die (OR = 0.57), engage in self-harm outside the home (OR = 0.71 and 0.78), and attribute their self-harm to romantic relationship problems (OR = 0.76); however, they were more likely to use instruments, to jump, or to choose other methods (OR = 3.73, 3.83, and 7.71, respectively).ConclusionsAmong hotline callers, many episodes of self-harm did not receive medical treatment, despite over half reporting a wish to die. Characteristics of self-harm behaviors were different between treated and untreated self-harm callers. Our findings suggest that more strategies should improve access to hospital-based medical treatment and coverage for post-intervention for self-harmers who are not presented in hospitals.
Highlights
Self-harm, which refers to intentional bodily self-harm irrespective of motivation and degree of suicide intent, is a global public health problem (Haagsma et al, 2016)
While we divided the data into male and female subsamples, the results of the two subsamples indicated similar findings with combined sample, except for the place where self-harm occurred did not associated with receiving medical treatment in either of the male or the female subsample
We describe the characteristics of hotline callers and most recent episode of non-fatal self-harm
Summary
Self-harm, which refers to intentional bodily self-harm irrespective of motivation and degree of suicide intent, is a global public health problem (Haagsma et al, 2016). Considering the large proportion of untreated acts among self-harm (Geulayov et al, 2018), it is important to explore and understand the characteristics of individuals presenting with self-harm who did not receive hospital-based medical treatment Such an understanding would contribute to developing more specific and effective prevention strategies for the self-harm, and, to some extent, help us estimate the prevalence of non-fatal self-harm in China more accurately. Our findings suggest that more strategies should improve access to hospital-based medical treatment and coverage for post-intervention for self-harmers who are not presented in hospitals
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