Girls more likely than boys to be admitted to hospital after self-harming

A study, published in the Archives of Disease in Childhood, reveals a gender disparity that is particularly evident among ten to fifteen year olds who have self-harmed.

Most analyses of self-harm among young people have been restricted to hospital admissions or primary care data. But Swansea University say this research, led by Professor Ann John, from their Medical School, captured the full spectrum of those accessing healthcare and looked at data from GPs, emergency care departments and outpatient clinics, and hospital admissions for 2003 to 2015 in Wales.

The researchers used the Adolescent Mental Health Data Platform, a research platform created by Ann John to enable child and adolescent mental health research, and the SAIL Databank, a data repository dedicated to providing a safe and trusted means of harnessing population scaled data.

The study included 937,697 young people, aged between ten and twenty four, of whom 15,739 had accessed healthcare services for self-harm.

Their findings showed:

  • Young people from deprived areas were most at risk. Self-harm rates were more than double those in areas of least deprivation
  • Although most youngsters accessed primary care services, the number of young people attending emergency care and subsequently being admitted to hospital did increase
  • Rates of self-harm were highest among fifteen to nineteen year olds, but from 2011 the largest increases were seen among ten to fourteen year olds, particularly girls
  • Hospital admissions for this younger age group almost doubled among boys and young men, and more than doubled among girls and young women
  • However boys who attended emergency care after harming themselves were much less likely to be admitted to hospital than girls, a pattern the researchers branded “a cause for concern”
  • 58% of those seeking emergency care for self-harm were boys and young men

The gender disparity was most evident among ten to fifteen year olds. 76% of girls in this age group were admitted to hospital compared to 49% of boys. 90% of girls who had poisoned themselves were admitted to hospital, compared to 69% of boys of the same age group.

Ann John, who is also Chair of the National Advisory Group to Welsh Government on Suicide and Self-harm Prevention, said “Our findings highlight the opportunities for early intervention when young people attend or are brought into contact with health services for self-harm, especially in primary care and emergency departments.

“There are initiatives to improve help-seeking in boys and young men but we also need to consider if, when they do attend, we manage them differently to girls and young women.”

The researchers emphasised that this observational study cannot establish causes and only reflects contacts made with healthcare services rather than actual numbers of young people who self-harm in the community.

But they suggest, given that the data is based on a large sample of the population over a period of twelve years, the results are likely to be applicable to the rest of the UK.

In September the Welsh Government issued guidance to all schools in Wales regarding self-harm in young people which was developed by Ann John and her colleagues following a workshop which included discussions of the study’s findings.

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