Monitoring of Intentional Self-Harm as a Tool to Detect Mental Disorders and Improve Access to Psychiatric Care.

Abstract

This article discusses the early diagnosis of mental disorders in connection with non-fatal intentional self-harm and suicide prevention. To substantiate the efficacy of an intentional self-harm monitoring system as a tool for detecting mental disorders and improving access to psychiatric care for people who have attempted suicide. A cohort study was performed using materials obtained after the introduction of an intentional self-harm monitoring system and its implementation in the Stavropol Territory. We studied 2738 cases of intentional self-harm reported between 2016 and 2021. Study data were grouped using dual criteria based on a history of psychiatric follow-up, a history of psychiatric counseling, first/recurrent intentional self-harm, psychiatric examination after intentional self-harm, and a diagnosis of a mental disorder on psychiatric examination. The official suicide attempt registration system was found to identify less than 15% of attempts. The primary incidence of mental disorders in suicide attempters was 61.4 times higher than the primary incidence of mental disorders in the general population of the Stavropol Territory. A supposedly healthy suicide attempter was 169 times more likely to be diagnosed with a mental disorder than a member of the general population. Primary diagnoses of mental disorders were 14.8 times more common in multiple suicide attempters without a diagnosis of a mental disorder at the time of the last attempt than in first-time attempters. Access to psychiatric care increases the mental disorder diagnosis rate in general and in suicide attempters in particular. Monitoring of intentional self-harm is instrumental in the early diagnosis of mental disorders, suicide prevention, and improving access to psychiatric care for suicide attempters, also having an enormous research potential.