Abstract
BackgroundLittle is known about the methods of deliberate self-harm (DSH) in South Africa (SA), despite the importance of means restriction as a public health strategy to reduce the morbidity and mortality associated with self-harm.AimThe aim of this study was to investigate the range of methods used in DSH and identify the socio-demographic and clinical factors associated with violent and non-violent methods of DSH among patients treated at a tertiary hospital in SA.SettingThe study was conducted at an urban, tertiary level emergency department at Groote Schuur hospital in Cape Town, South Africa.MethodData were collected from 238 consecutive DSH patients who presented for emergency department treatment at the hospital. Logistic regression models were used to explore the factors associated with violent and non-violent methods of DSH.ResultsSelf-poisoning was the most common method of self-harm (80.3%). Prescription medication was the most common form of self-poison (57.6%), while a large number of patients used non-prescription paracetamol (40.9%). In the regression analysis, male gender, stating that the reason for DSH was to escape a situation and history of substance use were associated with violent method of DSH.ConclusionImproved monitoring of prescription medications commonly used in DSH is integral to public health suicide prevention strategies in SA. This study underscores the need for substance use interventions in the healthcare setting.
Highlights
In South Africa (SA), suicide is a serious public health concern[1] accounting for approximately 9.6% of unnatural deaths and yielding an annual prevalence rate of 13.25 per 100 000.2 Studies in this country have consistently shown that common methods of suicide are hanging, firearms and poisoning.[2,3,4] Globally, 30% of all fatal suicide attempts are because of pesticide self-poisoning, occurring most frequently in rural agricultural areas.[5]Researchers recognise the confusing and often contradictory definitions of suicide and suicide behaviour in the literature.[6]
Male gender, stating that the reason for deliberate self-harm (DSH) was to escape a situation and history of substance use were associated with violent method of DSH
Our study found no incidents involving firearms and a relatively small number of patients who jumped from a height
Summary
In South Africa (SA), suicide is a serious public health concern[1] accounting for approximately 9.6% of unnatural deaths and yielding an annual prevalence rate of 13.25 per 100 000.2 Studies in this country have consistently shown that common methods of suicide are hanging, firearms and poisoning.[2,3,4] Globally, 30% of all fatal suicide attempts are because of pesticide self-poisoning, occurring most frequently in rural agricultural areas.[5]Researchers recognise the confusing and often contradictory definitions of suicide and suicide behaviour in the literature.[6]. In South Africa (SA), suicide is a serious public health concern[1] accounting for approximately 9.6% of unnatural deaths and yielding an annual prevalence rate of 13.25 per 100 000.2 Studies in this country have consistently shown that common methods of suicide are hanging, firearms and poisoning.[2,3,4] Globally, 30% of all fatal suicide attempts are because of pesticide self-poisoning, occurring most frequently in rural agricultural areas.[5]. Deliberate self-harm with intent to die is a form of suicidal behaviour. Little is known about the methods of deliberate self-harm (DSH) in South Africa (SA), despite the importance of means restriction as a public health strategy to reduce the morbidity and mortality associated with self-harm
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