Identifying typologies among persons admitted to hospital for non-fatal intentional self-harm in Victoria, Australia

Angela J Clapperton

doi:10.1007/s00127-019-01747-1

Abstract

PurposeThe aim of this study was to determine whether people who have been hospitalised as the result of non-fatal self-harm form meaningful groups based on mechanism of injury, and demographic and mental health-related factors.MethodsA retrospective analysis of 18,103 hospital admissions for self-harm in Victoria, Australia over the 3-year period 2014/2015–2016/2017 recorded on the Victorian Admitted Episodes Dataset (VAED). The VAED records all hospital admissions in public and private hospitals in Victoria. The primary analysis used a two-step method of cluster analysis. Initial analysis determined two distinct groups, one composed of individuals who had a recorded mental illness diagnosis and one composed of individuals with no recorded mental illness diagnosis. Subsequent cluster analysis identified four subgroups within each of the initial two groups.ResultsWithin the diagnosed mental illness subgroups, each subgroup was characterised by a particular mental disorder or a combination of disorders. Within the no diagnosis of mental illness groups, the youngest group was also the most homogenous (all females who self-poisoned), the oldest group had a high proportion of rural/regional residents, the group with the highest proportion of males also had the highest proportion of people who used cutting as the method of self-harm, and the group with the highest proportion of metropolitan residents also had the highest proportion of people who were married.ConclusionsPreventative interventions need to take into account that those who are admitted to hospital for self-harm are a heterogeneous group.

Highlights

Intentional self-harm or self-injurious behaviour includes a range of behaviours that cause direct and deliberate harm to oneself, including non-suicidal self-injury, suicidal behaviour, and suicide [1,2,3]
Intentional self-harm resulting in hospital treatment is widespread in Australia and while important in its own right, it has been shown to increase the risk of subsequent suicide [4, 5]
Self-harm accounted for 4.7% of injury admissions among persons aged 10 years and older over the study period

Summary

Introduction

Intentional self-harm or self-injurious behaviour includes a range of behaviours that cause direct and deliberate harm to oneself, including non-suicidal self-injury, suicidal behaviour, and suicide [1,2,3]. Intentional self-harm ( referred to as self-harm) resulting in hospital treatment is widespread in Australia and while important in its own right, it has been shown to increase the risk of subsequent suicide [4, 5]. A comprehensive national study showed more than 20,000 Australians were admitted to hospital each year since 2000 as a result of self-harm [8] and recent research has documented the increasing burden of non-fatal self-harm and other mental health-related Emergency Department (ED) presentations and hospitalisations in Australia [9,10,11,12]. A recent Victorian study showed that self-harm ED presentation rates increased by an annual average of 3.2% among all adults over the 10-year period 2006/2007–2015/2016 [9].

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