Projects relating to Self-Harm

MaSH projects: ongoing

Multicentre study of self-harm in England - 1 April 2008 to 31 March 2018

Abstract

In England and Wales there are at least 200,000 general hospital presentations for self-harm (intentional self-poisoning or self-injury) per year. Self-harm occurs in relation to a wide range of personal problems, emotional turmoil and psychiatric disorders. It carries a significant risk of subsequent suicide and has major impacts on family members and friends. It also places pressure on busy emergency departments, wards and clinicians, as well as having major financial costs for the NHS.

The aim of this programme of research is to conduct a series of related studies on the epidemiology, causes, clinical management, outcome and prevention of self-harm. Through a multicentre collaboration the research provides representative and reliable data on self-harm in England. It contributes to the National Suicide Prevention Strategy for England (2002, 2012) and prevention and service initiative, including NICE guidance on self-harm (National Collaborating Centre for Mental Health 2004, 2011).

The research is a collaboration between the University of Oxford (Principal Investigator Professor Keith Hawton), the University of Manchester (Leads, Professor Nav Kapur and Dr Jayne Cooper), and Derbyshire Healthcare NHS Foundation Trust (Lead, Mr Keith Waters). Data for the study are collected in these three centres in six general hospitals, one in Oxford, three in Manchester and two in Derby. Over 10 collaborating researchers are part of the research group. The project also has input from service users.

Duration of the project

1 April 2008 to 31 March 2018

Funding body

The Multicentre study of self-harm in England is funded by The Department of Health.

Members of the project

Professor Keith HawtonPrincipal investigator
Professor Nav KapurPrincipal investigator
Mr Keith WatersPrincipal investigator

The programme of research includes 4 broad areas:

  • Epidemiology and trends in self-harm.
  • Clinical management of self-harm.
  • Outcome of self-harm, including repetition and mortality.
  • Pharmaco-epidemiology, including drug toxicology and impacts of changes in prescribing legislation and trends.

Outputs

  • Clements, C., Turnbull, P., Hawton, K., Geulayov, G., Waters, K., Ness, J., ... Kapur, N. (2016). Rates of self-harm presenting to general hospitals: a comparison of data from the Multicentre Study of Self-Harm in England and Hospital Episode Statistics. BMJ open, 6(2), e009749. DOI: 10.1136/bmjopen-2015-009749. Publication link: 9b635fcc-dbaf-49a9-b550-ba8bb7ea2436 | PubMed:26883238
  • Geulayov, G., Kapur, N., Turnbull, P., Clements, C., Waters, K., Ness, J., ... Hawton, K. (2016). Epidemiology and trends in non-fatal self-harm in three centres in England, 2000-2012: findings from the Multicentre Study of Self-harm in England. BMJ open, 6(4), e010538. DOI: 10.1136/bmjopen-2015-010538. Publication link: 82c90072-c5bf-4c81-9a7e-341599c45327 | PubMed:27130163
  • Hawton, K., Bergen, H., Geulayov, G., Waters, K., Ness, J., Cooper, J., & Kapur, N. (2016). Impact of the recent recession on self-harm: Longitudinal ecological and patient-level investigation from the Multicentre Study of Self-harm in England.Journal of affective disorders, 191. DOI: 10.1016/j.jad.2015.11.001. Publication link: 1e8c7b0f-4be1-48bb-a423-a5f639e587b5 | PubMed:26655123
  • Cooper, J., Steeg, S., Gunnell, D., Webb, R., Hawton, K., Bennewith, O., ... Kapur, N. (2015). Variations in the hospital management of self-harm and patient outcome: a multi-site observational study in England.Journal of affective disorders, 174, 101-105. DOI: 10.1016/j.jad.2014.11.037. Publication link: d3df9c04-a8bf-40f4-935a-50da17eda910 | PubMed:25496757
  • Hawton, K., Bergen, H., Cooper, J., Turnbull, P., Waters, K., Ness, J., & Kapur, N. (2015). Suicide following self-harm: Findings from the Multicentre Study of self-harm in England, 2000–2012. Journal of Affective Disorders, 175(0), 147-151. DOI: 10.1016/j.jad.2014.12.062. Publication link: fce3ce22-768d-4adb-bc27-1ec913ffdd27
  • Kapur, N., Steeg, S., Turnbull, P., Webb, R., Bergen, H., Hawton, K., ... Cooper, J. (2015). Hospital management of suicidal behaviour and subsequent mortality: a prospective cohort study.The Lancet Psychiatry, 2, 809-816. DOI: 10.1016/S2215-0366(15)00169-8. Publication link: 05983268-2d48-40e9-84db-af495eeaec85 | PubMed:26254717
  • Ness, J., Hawton, K., Bergen, H., Cooper, J., Steeg, S., Kapur, N., ... Waters, K. (2015). Alcohol use and misuse, self-harm and subsequent mortality: an epidemiological and longitudinal study from the multicentre study of self-harm in England. Emergency Medicine Journal. DOI: 10.1136/emermed-2013-202753. Publication link: 34b40916-21ce-46c1-8089-bd2a3970184c
  • Owens, D., Kelley, R., Munyombwe, T., Bergen, H., Hawton, K., Cooper, J., ... Kapur, N. (2015). Switching methods of self-harm at repeat episodes: Findings from a multicentre cohort study.Journal of affective disorders, 180. DOI: 10.1016/j.jad.2015.03.051. Publication link: 5b01e08b-cbe6-42f3-a140-d157e52dc2b4 | PubMed:25881280
  • Townsend, E., Ness, J., Waters, K., Kapur, N., Turnbull, P., Cooper, J., ... Hawton, K. (2015). Self-harm and life problems: findings from the Multicentre Study of Self-harm in England.Social psychiatry and psychiatric epidemiology. DOI: 10.1007/s00127-015-1136-9. Publication link: 9980d78e-d019-4335-a9ce-66d5cf574816 | PubMed:26499114
  • Turnbull, P., Webb, R., Kapur, N., Clements, C., Bergen, H., Hawton, K., ... Cooper, J. (2015). Variation by ethnic group in premature mortality risk following self-harm: a multicentre cohort study in England.BMC Psychiatry, 15(1). DOI: 10.1186/s12888-015-0637-0. Publication link: e2599488-12f9-4c37-8838-7fd462ba8ac3 | PubMed:26482436
  • Bergen, H., Hawton, K., Webb, R., Cooper, J., Steeg, S., Haigh, M., ... Kapur, N. (2014). Alcohol-related mortality following self-harm: a multicentre cohort study.JRSM open, 5(8). DOI: 10.1177/2054270414533326. Publication link: 5ef8aab5-3ef8-4b61-a2c5-377484220993 | PubMed:25289146
  • Cooper, J., Steeg, S., Webb, R., Stewart, S. L. K., Applegate, E., Hawton, K., ... Kapur, N. (2013). Risk factors associated with repetition of self-harm in black and minority ethnic (BME) groups: A multi-centre cohort study. Journal of Affective Disorders, 148(2-3), 435-439. DOI: 10.1016/j.jad.2012.11.018. Publication link: f552540e-36f8-4d99-a052-449c9f2ca8af | PubMed:23228569
  • Kapur, N., Cooper, J., O'Connor, R. C., & Hawton, K. (2013). Non-suicidal self-injury v. attempted suicide: New diagnosis or false dichotomy?British Journal of Psychiatry, 202(5), 326-328. DOI: 10.1192/bjp.bp.112.116111. Publication link: 7c8cb82c-e455-4b84-9327-543cd4f014c2 | PubMed:23637107
  • Kapur, N., Steeg, S., Webb, R., Haigh, M., Bergen, H., Hawton, K., ... Cooper, J. (2013). Does Clinical Management Improve Outcomes following Self-Harm? Results from the Multicentre Study of Self-Harm in England. PLoS ONE, 8(8), [e70434]. DOI: 10.1371/journal.pone.0070434. Publication link: 85506e00-1954-4e52-9b13-2602637741f7
  • Bergen, H., Hawton, K., Kapur, N., Cooper, J., Steeg, S., Ness, J., & Waters, K. (2012). Shared characteristics of suicides and other unnatural deaths following non-fatal self-harm? A multicentre study of risk factors. Psychological Medicine, 42(4), 727-741. DOI: 10.1017/S0033291711001747. Publication link: a51a006f-e5ef-42be-b188-457f58321b6c | PubMed:21910932
  • Bergen, H., Hawton, K., Waters, K., Ness, J., Cooper, J., Steeg, S., & Kapur, N. (2012). How do methods of non-fatal self-harm relate to eventual suicide?Journal of Affective Disorders, 136(3), 526-533. DOI: 10.1016/j.jad.2011.10.036. Publication link: 568789db-8364-4d0d-8bd2-b861d7e4a240 | PubMed:22127391
  • Bergen, H., Hawton, K., Waters, K., Ness, J., Cooper, J., Steeg, S., & Kapur, N. (2012). Premature death after self-harm: A multicentre cohort study. The Lancet, 380(9853), 1568-1574. DOI: 10.1016/S0140-6736(12)61141-6. Publication link: 365495fc-ddb6-4835-a416-46c5f6933036 | PubMed:22995670
  • Hawton, K., Bergen, H., Kapur, N., Cooper, J., Steeg, S., Ness, J., & Waters, K. (2012). Repetition of self-harm and suicide following self-harm in children and adolescents: Findings from the Multicentre Study of Self-harm in England. Journal of Child Psychology and Psychiatry and Allied Disciplines, 53(12), 1212-1219. DOI: 10.1111/j.1469-7610.2012.02559.x. Publication link: 13274203-b807-4a38-95d8-3b73b46509f7 | PubMed:22537181
  • Hawton, K., Bergen, H., Waters, K., Ness, J., Cooper, J., Steeg, S., & Kapur, N. (2012). Epidemiology and nature of self-harm in children and adolescents: Findings from the multicentre study of self-harm in England. European Child and Adolescent Psychiatry, 21(7), 369-377. DOI: 10.1007/s00787-012-0269-6. Publication link: 845c705d-871e-4677-b446-437ad01136b4 | PubMed:22447195
  • Steeg, S., Kapur, N., Webb, R., Applegate, E., Stewart, S., Hawton, K., ... Cooper, J. (2012). The development of a population-level clinical screening tool for self-harm repetition and suicide: The ReACT Self-Harm Rule. Psychological Medicine, 42(11), 2383-2394. DOI: 10.1017/S0033291712000347. Publication link: b22fe39a-aa60-43dc-8342-05f3ddced346 | PubMed:22394511
  • Hawton, K., Bergen, H., Simkin, S., Arensman, E., Corcoran, P., Cooper, J., ... Kapur, N. (2011). Impact of different pack sizes of paracetamol in the United Kingdom and Ireland on intentional overdoses: A comparative study. BMC public health, 11, [460]. DOI: 10.1186/1471-2458-11-460. Publication link: a06a2d1f-1b50-4ef4-97c7-d928b8e57cc4 | PubMed:21663604
  • Hawton, K., Bergen, H., Waters, K., Murphy, E., Cooper, J., & Kapur, N. (2011). Impact of withdrawal of the analgesic co-proxamol on nonfatal self-poisoning in the UK. Crisis, 32(2), 81-87. DOI: 10.1027/0227-5910/a000063. Publication link: 9f539d69-9435-45e0-91fb-991c08708ed7 | PubMed:21602162
  • Murphy, E., Kapur, N., Webb, R., & Cooper, J. (2011). Risk assessment following self-harm: Comparison of mental health nurses and psychiatrists. Journal of Advanced Nursing, 67(1), 127-139. DOI: 10.1111/j.1365-2648.2010.05484.x. Publication link: 7ad1dc30-d6ed-4407-86e7-145e3dde9836 | PubMed:20969616
  • Bergen, H., Hawton, K., Waters, K., Cooper, J., & Kapur, N. (2010). Epidemiology and trends in non-fatal self-harm in three centres in England: 2000-2007. British Journal of Psychiatry, 197(6), 493-498. DOI: 10.1192/bjp.bp.110.077651. Publication link: 393e97b6-669c-4060-a8c4-7831516f919f | PubMed:21119156
  • Bergen, H., Hawton, K., Waters, K., Cooper, J., & Kapur, N. (2010). Psychosocial assessment and repetition of self-harm: The significance of single and multiple repeat episode analyses. Journal of Affective Disorders, 127(1-3), 257-265. DOI: 10.1016/j.jad.2010.05.001. Publication link: 3e7667e5-1b46-4c32-997c-f8f2c37dedc2 | PubMed:20684848
  • Bergen, H., Murphy, E., Cooper, J., Kapur, N., Stalker, C., Waters, K., & Hawton, K. (2010). A comparative study of non-fatal self-poisoning with antidepressants relative to prescribing in three centres in England. Journal of Affective Disorders, 123(1-3), 95-101. DOI: 10.1016/j.jad.2009.10.004. Publication link: 9945a17c-2cb5-4451-8db7-32e129476dec | PubMed:19864029
  • Cooper, J., Murphy, E., Webb, R., Hawton, K., Bergen, H., Waters, K., & Kapur, N. (2010). Ethnic differences in self-harm, rates, characteristics and service provision: Three-city cohort study. British Journal of Psychiatry, 197(3), 212-218. DOI: 10.1192/bjp.bp.109.072637. Publication link: 9edc4f7e-136b-4e31-bd79-0e17f3f72a49 | PubMed:20807966
  • Hawton, K., Bergen, H., Simkin, S., Cooper, J., Waters, K., Gunnell, D., & Kapur, N. (2010). Toxicity of antidepressants: Rates of suicide relative to prescribing and non-fatal overdose. British Journal of Psychiatry, 196(5), 354-358. DOI: 10.1192/bjp.bp.109.070219. Publication link: 1fd00085-ede2-4edc-9720-a03ec571aff3 | PubMed:20435959
  • Bergen, H., Hawton, K., Murphy, E., Cooper, J., Kapur, N., Stalker, C., & Waters, K. (2009). Trends in prescribing and self-poisoning in relation to UK regulatory authority warnings against use of SSRI antidepressants in under-18-year-olds. British Journal of Clinical Pharmacology, 68(4), 618-629. DOI: 10.1111/j.1365-2125.2009.03481.x. Publication link: 5fa6c1cb-28e0-4161-a531-4b68078121df | PubMed:19843065
  • Hawton, K., Bergen, H., Simkin, S., Brock, A., Griffiths, C., Romeri, E., ... Gunnell, D. (2009). Effect of withdrawal of co-proxamol on prescribing and deaths from drug poisoning in England and Wales: time series analysis.BMJ, 338. DOI: 10.1136/bmj.b2270. Publication link: 4246c619-fd43-4ea7-875d-96189f2f56f0 | PubMed:19541707
  • Taylor, T. L., Hawton, K., Fortune, S., & Kapur, N. (2009). Attitudes towards clinical services among people who self-harm: Systematic review. British Journal of Psychiatry, 194(2), 104-110. DOI: 10.1192/bjp.bp.107.046425. Publication link: 468d6adc-34e2-42b1-b08d-e9e06acc0554
  • Gunnell, D., Hawton, K., Ho, D., Evans, J., O'Connor, S., Potokar, J., ... Kapur, N. (2008). Hospital admissions for self harm after discharge from psychiatric inpatient care: Cohort study. BMJ, 337(7682), 1331-1334. DOI: 10.1136/bmj.a2278. Publication link: 40fd0d6e-773d-4d4f-824f-a37de3cf77ce
  • Kapur, N., Murphy, E., Cooper, J., Bergen, H., Hawton, K., Simkin, S., ... Owens, D. (2008). Psychosocial assessment following self-harm: Results from the Multi-Centre Monitoring of Self-Harm Project. Journal of Affective Disorders, 106(3), 285-293. DOI: 10.1016/j.jad.2007.07.010. Publication link: b8085242-beb6-4b5c-b232-11f87a5c999a
  • Lilley, R., Owens, D., Horrocks, J., House, A., Noble, R., Bergen, H., ... Kapur, N. (2008). Hospital care and repetition following self-harm: Multicentre comparison of self-poisoning and self-injury. British Journal of Psychiatry, 192(6), 440-445. DOI: 10.1192/bjp.bp.107.043380. Publication link: 01494957-cc38-429a-80c7-9965b81e5ed7 | PubMed:18515895