Projects relating to Self-Harm

Associated projects: ongoing

A multi-centre programme of clinical and public health research to guide health service priorities for preventing suicide in England.

Abstract

Every year in England there are nearly 5,000 suicides and an estimated 200,000 hospital attendances following self-harm ('attempted suicide').

The overall aim of our research is to provide new evidence to help prevent suicide and improve the care of people who self-harm. The programme was developed in response to three key issues identified in the National Suicide Prevention Strategy 2012:

  • The adverse impact of the economic crisis on suicide
  • Improving the care of people who self-harm
  • Identifying and reducing access to high-lethality methods of suicide.

Duration of the project

2012-2016

Funding body

The Department of Health

Members of the project

Professor D GunnellPrincipal investigator
Professor K HawtonPrincipal investigator
Professor Nav KapurPrincipal investigator

1. Assessing and responding to the impact of the economic crisis

Using national suicide and self-harm data, Coroners’ records of recession associated suicide, and in-depth qualitative interviews with people whose self-harm had been precipitated by employment or financial difficulties, we will a) identify who is at greatest risk of suicide in the current economic crisis and b) develop and pilot interventions aimed at reducing their risk.

2. Improving services for self-harm

  • Using descriptive and cohort studies with economic modelling we will identify which risk assessment tools are used by health services, which tools have the best predictive value, and which might be most cost-effective
  • We will carry out a systematic review, a retrospective case record study and focus groups to assess how self-harm associated with an advance decision is best managed
  • Using qualitative interviews we will develop a Healthtalkonline website and guide for parents and carers of young people who self-harm and produce guidelines for self-harm services.

3. The emergence of new suicide methods

  • We will use time trend analysis to assess the emergence of novel methods of suicide, and use Coroners records to investigate opportunities for preventing these deaths
  • We will use national suicide mortality data, data from the Multicentre Study of Self-Harm in England (Oxford, Derby and Manchester), and prescription data to analyse relative toxicity and case fatality in relation to overdoses of five groups of medicines commonly used in suicides by self-poisoning. Findings will be reported to the MHRA (The Medicines and Healthcare products Regulatory Agency).

Outputs

  • Quinlivan, L., Cooper, J., Davies, L., Hawton, K., Gunnell, D., & Kapur, N. (2016). Which are the most useful scales for predicting repeat self-harm? A systematic review evaluating risk scales using measures of diagnostic accuracy.BMJ open, 6(2), [e009297]. DOI: 10.1136/bmjopen-2015-009297. Publication link: 4e0336ca-ca9d-4dd0-b3be-ca249b716ae6 | PubMed:26873046
  • Quinlivan, L., Cooper, J., Davies, L., Hawton, K., Gunnell, D., & Kapur, N. (2014). Diagnostic accuracy of risk scales for repeat self-harm: What are the best risk scales? In host publication. ESSSB15. . Publication link: a19bbd8b-5212-4b88-b1c8-7fc17ded6433
  • Quinlivan, L., Cooper, J., Steeg, S., Davies, L., Hawton, K., Gunnell, D., & Kapur, N. (2014). Scales for predicting risk following self-harm: An observational study in 32 hospitals in England. BMJ open, 4(5), [e004732]. DOI: 10.1136/bmjopen-2013-004732. Publication link: c9169a22-a1d9-4f9a-b6a6-c4384f846928 | PubMed:24793255
  • Quinlivan, L., Cooper, J., Steeg, S., Davies, L., Hawton, K., Gunnell, D., & Kapur, N. (2014). Scales for predicting risk following self-harm: an observational study in 32 hospitals in England. In host publication. ESSSB15. . Publication link: c8b91f41-05aa-40ec-b01e-d23ba5487310