Admissions to hospital for deliberate self-harm in England 1995-2000: an analysis of Hospital Episode Statistics

Background Rates of deliberate self-harm (DSH) were increasing in the United Kingdom during the 1980s and early 1990s, particularly among young adult males. Self-poisoning with paracetamol was the most common means, with overdoses of anti-depressants becoming more frequent. Changes to paracetamol pack size regulations in 1997 have been followed by a reduction in overdoses, and there has been more prescription of anti-depressants less likely to necessitate hospitalization if overdosed. Improved liaison psychiatry services and increased levels of employment are among the factors that would suggest an impact on hospital admissions for self-harm. This study analysed DSH admissions to hospitals in England from 1995/96 to 1999/2000 to examine changes. Methods A retrospective analysis of the Hospital Episode Statistics database was carried out. Results Hospital admissions for DSH rose to 153 per 100 000 in 1997/98, then declined to 143 per 100 000 in 1999/2000. Paracetamol overdoses decreased from 77 to 67 per 100 000. The use of anti-depressants or tranquillizers grew from 56 to 75 per 100 000 during the 5 years. Self-injury, narcotics overdoses and the use of alcohol continued to increase over time. Conclusions Yearly increases in admissions for DSH to hospitals in England reversed in 1998/99 and stabilized in 1999/2000. These changes were most noticeable for the 16-24 years age group. The use of paracetamol decreased, whereas other means of self-harm increased. Regional differences and the relationship between rates of DSH in the community and hospital should be explored further.