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1.
J Affect Disord Rep ; 6: 100271, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1828734

ABSTRACT

BACKGROUND: The COVID-19 pandemic has had an impact on the mental health of healthcare and social care workers, and its potential effect on suicidal thoughts and behaviour is of particular concern. METHODS: This systematic review identified and appraised the published literature that has reported on the impact of COVID-19 on suicidal thoughts and behaviour and self-harm amongst healthcare and social care workers worldwide up to May 31, 2021. RESULTS: Out of 37 potentially relevant papers identified, ten met our eligibility criteria. Our review has highlighted that the impact of COVID-19 has varied as a function of setting, working relationships, occupational roles, and psychiatric comorbidities. LIMITATIONS: There have been no completed cohort studies comparing pre- and post-pandemic suicidal thoughts and behaviours. It is possible some papers may have been missed in the search. CONCLUSIONS: The current quality of evidence pertaining to suicidal behaviour in healthcare workers is poor, and evidence is entirely absent for those working in social care. The clinical relevance of this work is to bring attention to what evidence exists, and to encourage, in practice, proactive approaches to interventions for improving healthcare and social care worker mental health.

2.
Crisis ; 2022 Apr 06.
Article in English | MEDLINE | ID: covidwho-1778574

ABSTRACT

Background: Associations between sensational news coverage of suicide and increases in suicidal behavior have been well documented. Amid growing concern over the impact of the COVID-19 pandemic on suicide rates, it is especially important that news coverage adheres to recommended standards. Method: We analyzed the quality and content of print and online UK news reports of possible COVID-19-related suicides and suicide attempts in the first 4 months of the pandemic (N = 285). Results: The majority of reports made explicit links between suicidal behavior and the COVID-19 pandemic in the headline (65.5%), largely based on statements by family, friends, or acquaintances of the deceased (60%). The impact of the pandemic on suicidal behavior was most often attributed to feelings of isolation (27.4%), poor mental health (14.7%), and entrapment due to government-imposed restrictions (14.4%). Although rarely of poor overall quality, reporting was biased toward young people, frontline staff, and relatively unusual suicides and, to varying degrees, failed to meet recommended standards (e.g., 41.1% did not signpost readers to sources of support). Limitations: This analysis cannot account for the impact of reporting on suicide. Conclusion: Careful attention must be paid to the quality and content of reports, especially as longer-term consequences of the pandemic develop.

3.
BMJ Open ; 12(4): e054061, 2022 Apr 04.
Article in English | MEDLINE | ID: covidwho-1774957

ABSTRACT

INTRODUCTION: Pesticide self-poisoning kills an estimated 110 000-168 000 people worldwide annually. Data from South Asia indicate that in 15%-20% of attempted suicides and 30%-50% of completed suicides involving pesticides these are purchased shortly beforehand for this purpose. Individuals who are intoxicated with alcohol and/or non-farmers represent 72% of such customers. We have developed a 'gatekeeper' training programme for vendors to enable them to identify individuals at high risk of self-poisoning (gatekeeper function) and prevent such individuals from accessing pesticides (means restriction). The primary aim of the study is to evaluate the effectiveness of the gatekeeper intervention in preventing pesticide self-poisoning in Sri Lanka. Other aims are to identify method substitution and to assess the cost and cost-effectiveness of the intervention. METHODS AND ANALYSIS: A stepped-wedge cluster randomised trial of a gatekeeper intervention is being conducted in rural Sri Lanka with a population of approximately 2.7 million. The gatekeeper intervention is being introduced into 70 administrative divisions in random order at each of 30 steps over a 40-month period. The primary outcome is the number of pesticide self-poisoning cases identified from surveillance of hospitals and police stations. Secondary outcomes include: number of self-poisoning cases using pesticides purchased within the previous 24 hours, total number of all forms of self-harm and suicides. Intervention effectiveness will be estimated by comparing outcome measures between the pretraining and post-training periods across the divisions in the study area. The original study protocol has been adapted as necessary in light of the impact of the COVID-19. ETHICS AND DISSEMINATION: The Ethical Review Committee of the Faculty of Medicine and Allied Sciences, Rajarata University, Sri Lanka (ERC/2018/30), and the ACCORD Medical Research Ethics Committee, Edinburgh University (18-HV-053) approved the study. Results will be disseminated in scientific peer-reviewed journals. TRIAL REGISTRATION NUMBER: SLCTR/2019/006, U1111-1220-8046.


Subject(s)
COVID-19 , Pesticides , Commerce , Humans , Randomized Controlled Trials as Topic , Rural Population , Sri Lanka/epidemiology
4.
Pirkis, Jane, Gunnell, David, Shin, Sangsoo, DelPozo-Banos, Marcos, Arya, Vikas, Analuisa Aguilar, Pablo, Appleby, Louis, Arafat, S. M. Yasir, Arensman, Ella, Ayuso-Mateos, Jose Luis, Balhara, Yatan Pal Singh, Bantjes, Jason, Baran, Anna, Behera, Chittaranjan, Bertolote, Jose, Borges, Guilherme, Bray, Michael, Brečić, Petrana, Caine, Eric D.; Calati, Raffaella, Carli, Vladimir, Castelpietra, Giulio, Chan, Lai Fong, Chang, Shu-Sen, Colchester, David, Coss-Guzmán, Maria, Crompton, David, Curkovic, Marko, Dandona, Rakhi, De Jaegere, Eva, De Leo, Diego, Deisenhammer, Eberhard, Dwyer, Jeremy, Erlangsen, Annette, Faust, Jeremy, Fornaro, Michele, Fortune, Sarah, Garrett, Andrew, Gentile, Guendalina, Gerstner, Rebekka, Gilissen, Renske, Gould, Madelyn, Gupta, Sudhir Kumar, Hawton, Keith, Holz, Franziska, Kamenshchikov, Iurii, Kapur, Navneet, Kasal, Alexandr, Khan, Murad, Kirtley, Olivia, Knipe, Duleeka, Kolves, Kairi, Kölzer, Sarah, Krivda, Hryhorii, Leske, Stuart, Madeddu, Fabio, Marshall, Andrew, Memon, Anjum, Mittendorfer-Rutz, Ellenor, Nestadt, Paul, Neznanov, Nikolay, Niederkrotenthaler, Thomas, Nielsen, Emma, Nordentoft, Merete, Oberlerchner, Herwig, O'Connor, Rory, Papsdorf, Rainer, Partonen, Timo, Michael, Phillips, Platt, Steve, Portzky, Gwendolyn, Psota, Georg, Qin, Ping, Radeloff, Daniel, Reif, Andreas, Reif-Leonhard, Christine, Rezaeian, Mohsen, Román-Vázquez, Nayda, Roskar, Saska, Rozanov, Vsevolod, Sara, Grant, Scavacini, Karen, Schneider, Barbara, Semenova, Natalia, Sinyor, Mark, Tambuzzi, Stefano, Townsend, Ellen, Ueda, Michiko, Wasserman, Danuta, Webb, Roger T.; Winkler, Petr, Yip, Paul S. F.; Zalsman, Gil, Zoja, Riccardo, John, Ann, Spittal, Matthew J..
SSRN; 2022.
Preprint in English | SSRN | ID: ppcovidwho-331684

ABSTRACT

Background When the COVID-19 pandemic began there were concerns that suicides might rise, but predicted increases were not generally observed in the pandemic’s early months. However, the picture may be changing and patterns may vary across demographic groups. We aimed to provide an up-to-date, granular picture of the impact of COVID-19 on suicides globally.Methods We identified suicide data from official public-sector sources for countries/areas-within-countries. We used interrupted time series (ITS) analyses to model the association between the pandemic’s emergence and total suicides and suicides by sex-, age- and sex-by-age in each country/area-within-country. We compared the observed number of suicides to the expected number in the pandemic’s first nine and first 10-15 months and used meta-regression to explore sources of variation.Findings We sourced data from 33 countries (24 high-income, six upper-middle-income, three lower-middle-income). There was no evidence of greater-than-expected numbers of suicides in the majority of countries/areas-within-countries in any analysis;more commonly, there was evidence of lower-than-expected numbers. Certain sex, age and sex-by-age groups stood out as potentially concerning, but these were not consistent across countries/areas-within-countries. In the meta-regression, different patterns were not explained by countries’ COVID-19 mortality rate, stringency of public health response, level of economic support, or presence of a national suicide prevention strategy. They were also not explained by countries’ income level, although the meta-regression only included data from high-income and upper-middle-income countries, and there were suggestions from the ITS analyses that lower-middle-income countries fared less well.Interpretation Although there are some countries/areas-within-countries where overall suicide numbers and numbers for certain sex- and age-based groups are greater-than-expected, these are in the minority. Any upward movement in suicide numbers in any place or group is concerning, and we need to remain alert to and respond to changes as the pandemic and its mental health and economic consequences continue.

5.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-313480

ABSTRACT

Background: The COVID-19 pandemic has caused widespread morbidity and mortality as well as disruption to people’s lives and livelihoods around the world;this has occurred as a result of both infection with the virus itself and the health protection measures taken to curb its spread. There are concerns that rates of suicide, suicidal behaviours and self-harm may rise during and in the aftermath of the pandemic. Given the likely rapidly expanding research evidence base on the pandemic’s impact on rates of suicide, suicidal behaviours and self-harm and emerging evidence about how best to mitigate such effects, it is important that the best available knowledge is made readily available to policymakers, public health specialists and clinicians as soon as is possible. To facilitate this, we plan to undertake a living systematic review focusing on suicide prevention in relation to COVID-19. Method: Regular automated searches will feed into a web-based screening system which will also host the data extraction form for included articles. Our eligibility criteria are wide and include aspects of incidence and prevalence of suicidal behaviour, effects of exposures and effects of interventions in relation to the COVID-19 pandemic, with minimal restrictions on the types of study design to be included. The outcomes assessed will be death by suicide;self-harm or attempted suicide (including hospital attendance and/or admission for these reasons);and suicidal thoughts/ideation. There will be no restriction on study type, except for single case reports. There will be no restriction on language of publication. The review will be updated at three-monthly intervals if a sufficient volume of new evidence justifies doing so. Conclusions: Our living review will provide a regular synthesis of the most up-to-date research evidence to guide public health and clinical policy to mitigate the impact of COVID-19 on suicide. Protocol registration: PROSPERO CRD42020183326 01/05/2020

6.
ProQuest Central;
Preprint in English | ProQuest Central | ID: ppcovidwho-328222

ABSTRACT

Background: The COVID-19 pandemic has caused considerable morbidity, mortality and disruption to people’s lives around the world. There are concerns that rates of suicide and suicidal behaviour may rise during and in its aftermath. Our living systematic review synthesises findings from emerging literature on incidence and prevalence of suicidal behaviour as well as suicide prevention efforts in relation to COVID-19, with this iteration synthesising relevant evidence up to 19 th October 2020. Method:  Automated daily searches feed into a web-based database with screening and data extraction functionalities. Eligibility criteria include incidence/prevalence of suicidal behaviour, exposure-outcome relationships and effects of interventions in relation to the COVID-19 pandemic. Outcomes of interest are suicide, self-harm or attempted suicide and suicidal thoughts. No restrictions are placed on language or study type, except for single-person case reports. We exclude one-off cross-sectional studies without either pre-pandemic measures or comparisons of COVID-19 positive vs. unaffected individuals. Results: Searches identified 6,226 articles. Seventy-eight articles met our inclusion criteria. We identified a further 64 relevant cross-sectional studies that did not meet our revised inclusion criteria. Thirty-four articles were not peer-reviewed (e.g. research letters, pre-prints). All articles were based on observational studies. There was no consistent evidence of a rise in suicide but many studies noted adverse economic effects were evolving. There was evidence of a rise in community distress, fall in hospital presentation for suicidal behaviour and early evidence of an increased frequency of suicidal thoughts in those who had become infected with COVID-19. Conclusions:  Research evidence of the impact of COVID-19 on suicidal behaviour is accumulating rapidly. This living review provides a regular synthesis of the most up-to-date research evidence to guide public health and clinical policy to mitigate the impact of COVID-19 on suicide risk as the longer term impacts of the pandemic on suicide risk are researched.

7.
EuropePMC;
Preprint in English | EuropePMC | ID: ppcovidwho-327188

ABSTRACT

Background Evidence on the impacts of the pandemic on healthcare presentations for self-harm has accumulated rapidly. However, existing reviews do not include studies published beyond 2020. Aims To systematically review evidence on health services utilisation for self-harm during the COVID-19 pandemic. Methods A comprehensive search of multiple databases (WHO COVID-19 database;Medline;medRxiv;Scopus;PsyRxiv;SocArXiv;bioRxiv;COVID-19 Open Research Dataset, PubMed) was conducted. Studies reporting presentation frequencies for self-harm published from 1 st Jan. 2020 to 7 th Sept. 2021 were included. Study quality was assessed using a critical appraisal tool. Results Fifty-one studies were included. 59% (30/51) were rated as ‘low’ quality, 29% (15/51) as ‘moderate’ and 12% (6/51) as ‘high-moderate’. Most evidence (84%, 43/51 studies) was from high-income countries. 47% (24/51) of studies reported reductions in presentation frequency, including all 6 rated as high-moderate quality, which reported reductions of 17- 56%. Settings treating higher lethality self-harm were overrepresented among studies reporting increased demand. Two of the 3 higher quality studies including study observation months from 2021 reported reductions in service utilisation. Evidence from 2021 suggested increased use of health services following self-harm among adolescents, particularly girls. Conclusions Sustained reductions in service utilisation were seen into the first half of 2021. However, evidence from low- and middle-income countries is lacking. The increased use of health services among adolescents, particularly girls, into 2021 is of concern. Our findings may reflect changes in thresholds for help seeking, use of alternative sources of support and variable effects of the pandemic across different groups.

8.
Lancet Psychiatry ; 8(7): 579-588, 2021 07.
Article in English | MEDLINE | ID: covidwho-1683800

ABSTRACT

BACKGROUND: The COVID-19 pandemic is having profound mental health consequences for many people. Concerns have been expressed that, at their most extreme, these consequences could manifest as increased suicide rates. We aimed to assess the early effect of the COVID-19 pandemic on suicide rates around the world. METHODS: We sourced real-time suicide data from countries or areas within countries through a systematic internet search and recourse to our networks and the published literature. Between Sept 1 and Nov 1, 2020, we searched the official websites of these countries' ministries of health, police agencies, and government-run statistics agencies or equivalents, using the translated search terms "suicide" and "cause of death", before broadening the search in an attempt to identify data through other public sources. Data were included from a given country or area if they came from an official government source and were available at a monthly level from at least Jan 1, 2019, to July 31, 2020. Our internet searches were restricted to countries with more than 3 million residents for pragmatic reasons, but we relaxed this rule for countries identified through the literature and our networks. Areas within countries could also be included with populations of less than 3 million. We used an interrupted time-series analysis to model the trend in monthly suicides before COVID-19 (from at least Jan 1, 2019, to March 31, 2020) in each country or area within a country, comparing the expected number of suicides derived from the model with the observed number of suicides in the early months of the pandemic (from April 1 to July 31, 2020, in the primary analysis). FINDINGS: We sourced data from 21 countries (16 high-income and five upper-middle-income countries), including whole-country data in ten countries and data for various areas in 11 countries). Rate ratios (RRs) and 95% CIs based on the observed versus expected numbers of suicides showed no evidence of a significant increase in risk of suicide since the pandemic began in any country or area. There was statistical evidence of a decrease in suicide compared with the expected number in 12 countries or areas: New South Wales, Australia (RR 0·81 [95% CI 0·72-0·91]); Alberta, Canada (0·80 [0·68-0·93]); British Columbia, Canada (0·76 [0·66-0·87]); Chile (0·85 [0·78-0·94]); Leipzig, Germany (0·49 [0·32-0·74]); Japan (0·94 [0·91-0·96]); New Zealand (0·79 [0·68-0·91]); South Korea (0·94 [0·92-0·97]); California, USA (0·90 [0·85-0·95]); Illinois (Cook County), USA (0·79 [0·67-0·93]); Texas (four counties), USA (0·82 [0·68-0·98]); and Ecuador (0·74 [0·67-0·82]). INTERPRETATION: This is the first study to examine suicides occurring in the context of the COVID-19 pandemic in multiple countries. In high-income and upper-middle-income countries, suicide numbers have remained largely unchanged or declined in the early months of the pandemic compared with the expected levels based on the pre-pandemic period. We need to remain vigilant and be poised to respond if the situation changes as the longer-term mental health and economic effects of the pandemic unfold. FUNDING: None.


Subject(s)
COVID-19/complications , Global Health , Models, Statistical , Suicide/statistics & numerical data , Developed Countries/statistics & numerical data , Humans
9.
J Affect Disord Rep ; 6: 100271, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1531514

ABSTRACT

BACKGROUND: The COVID-19 pandemic has had an impact on the mental health of healthcare and social care workers, and its potential effect on suicidal thoughts and behaviour is of particular concern. METHODS: This systematic review identified and appraised the published literature that has reported on the impact of COVID-19 on suicidal thoughts and behaviour and self-harm amongst healthcare and social care workers worldwide up to May 31, 2021. RESULTS: Out of 37 potentially relevant papers identified, ten met our eligibility criteria. Our review has highlighted that the impact of COVID-19 has varied as a function of setting, working relationships, occupational roles, and psychiatric comorbidities. LIMITATIONS: There have been no completed cohort studies comparing pre- and post-pandemic suicidal thoughts and behaviours. It is possible some papers may have been missed in the search. CONCLUSIONS: The current quality of evidence pertaining to suicidal behaviour in healthcare workers is poor, and evidence is entirely absent for those working in social care. The clinical relevance of this work is to bring attention to what evidence exists, and to encourage, in practice, proactive approaches to interventions for improving healthcare and social care worker mental health.

10.
Lancet Psychiatry ; 8(7): 579-588, 2021 07.
Article in English | MEDLINE | ID: covidwho-1284642

ABSTRACT

BACKGROUND: The COVID-19 pandemic is having profound mental health consequences for many people. Concerns have been expressed that, at their most extreme, these consequences could manifest as increased suicide rates. We aimed to assess the early effect of the COVID-19 pandemic on suicide rates around the world. METHODS: We sourced real-time suicide data from countries or areas within countries through a systematic internet search and recourse to our networks and the published literature. Between Sept 1 and Nov 1, 2020, we searched the official websites of these countries' ministries of health, police agencies, and government-run statistics agencies or equivalents, using the translated search terms "suicide" and "cause of death", before broadening the search in an attempt to identify data through other public sources. Data were included from a given country or area if they came from an official government source and were available at a monthly level from at least Jan 1, 2019, to July 31, 2020. Our internet searches were restricted to countries with more than 3 million residents for pragmatic reasons, but we relaxed this rule for countries identified through the literature and our networks. Areas within countries could also be included with populations of less than 3 million. We used an interrupted time-series analysis to model the trend in monthly suicides before COVID-19 (from at least Jan 1, 2019, to March 31, 2020) in each country or area within a country, comparing the expected number of suicides derived from the model with the observed number of suicides in the early months of the pandemic (from April 1 to July 31, 2020, in the primary analysis). FINDINGS: We sourced data from 21 countries (16 high-income and five upper-middle-income countries), including whole-country data in ten countries and data for various areas in 11 countries). Rate ratios (RRs) and 95% CIs based on the observed versus expected numbers of suicides showed no evidence of a significant increase in risk of suicide since the pandemic began in any country or area. There was statistical evidence of a decrease in suicide compared with the expected number in 12 countries or areas: New South Wales, Australia (RR 0·81 [95% CI 0·72-0·91]); Alberta, Canada (0·80 [0·68-0·93]); British Columbia, Canada (0·76 [0·66-0·87]); Chile (0·85 [0·78-0·94]); Leipzig, Germany (0·49 [0·32-0·74]); Japan (0·94 [0·91-0·96]); New Zealand (0·79 [0·68-0·91]); South Korea (0·94 [0·92-0·97]); California, USA (0·90 [0·85-0·95]); Illinois (Cook County), USA (0·79 [0·67-0·93]); Texas (four counties), USA (0·82 [0·68-0·98]); and Ecuador (0·74 [0·67-0·82]). INTERPRETATION: This is the first study to examine suicides occurring in the context of the COVID-19 pandemic in multiple countries. In high-income and upper-middle-income countries, suicide numbers have remained largely unchanged or declined in the early months of the pandemic compared with the expected levels based on the pre-pandemic period. We need to remain vigilant and be poised to respond if the situation changes as the longer-term mental health and economic effects of the pandemic unfold. FUNDING: None.


Subject(s)
COVID-19/complications , Global Health , Models, Statistical , Suicide/statistics & numerical data , Developed Countries/statistics & numerical data , Humans
11.
J Psychiatr Res ; 137: 437-443, 2021 05.
Article in English | MEDLINE | ID: covidwho-1142073

ABSTRACT

INTRODUCTION: The COVID-19 pandemic and resulting public health measures may have major impacts on mental health, including on self-harm. We have investigated what factors related to the pandemic influenced hospital presentations following self-harm during lockdown in England. METHOD: Mental health clinicians assessing individuals aged 18 years and over presenting to hospitals in Oxford and Derby following self-harm during the period March 23rd to May 17, 2020 recorded whether the self-harm was related to the impact of COVID-19 and, if so, what specific factors were relevant. These factors were organized into a classification scheme. Information was also collected on patients' demographic characteristics, method of self-harm and suicide intent. RESULTS: Of 228 patients assessed, in 46.9% (N = 107) COVID-19 and lockdown restrictions were identified as influencing self-harm. This applied more to females than males (53.5%, N = 68/127 v 38.6%, N = 39/101, χ2 = 5.03, p = 0.025), but there were no differences in age, methods of self-harm or suicide intent between the two groups. The most frequent COVID-related factors were mental health issues, including new and worsening disorders, and cessation or reduction of services (including absence of face-to-face support), isolation and loneliness, reduced contact with key individuals, disruption to normal routine, and entrapment. Multiple, often inter-connected COVID-related factors were identified in many patients. CONCLUSIONS: COVID-related factors were identified as influences in nearly half of individuals presenting to hospitals following self-harm in the period following introduction of lockdown restrictions. Females were particularly affected. The fact that mental health problems, including issues with delivery of care, predominated has implications for organisation of services during such periods. The contribution of isolation, loneliness and sense of entrapment highlight the need for relatives, friends and neighbours to be encouraged to reach out to others, especially those living alone. The classification of COVID-related factors can be used as an aide-memoire for clinicians.


Subject(s)
COVID-19/epidemiology , COVID-19/prevention & control , Communicable Disease Control , Pandemics , Self-Injurious Behavior/epidemiology , Adolescent , Adult , England/epidemiology , Female , Humans , Male , Middle Aged , Physical Distancing , Young Adult
12.
The Lancet Psychiatry ; 8(1):15-17, 2021.
Article in English | APA PsycInfo | ID: covidwho-1104374

ABSTRACT

The letter reflects on the issue of suicide and the effect of news media on suicide and self-harm in the general population. News reporting on suicidal behaviour can have a considerable influence on suicide and self-harm in the general population. This issue is particularly relevant during the COVID-19 pandemic. With a rising number of deaths from COVID-19 infection and negative effects of the pandemic on key factors that are associated with suicide, including social isolation, unemployment, and financial problems, there is understandable concern that suicide rates might increase. Importantly, news reporting should not add to the potential risks of suicide. However, there is room for optimism, especially if one of the effects of the pandemic is increased social cohesion. Suicide rates have previously been shown to decline in some (but not all) large scale natural disasters and national crises. Also, media reporting of suicide is not inevitably associated with suicide rises, and indeed, might even help to prevent suicide. Including links in reports to sources of support and focusing on stories of hope and recovery could have protective effects against suicide, especially among individuals at higher risk. Encouraging people to look out for each other and encouraging those who are struggling to seek help can be a legitimate role for the media. Media reports can model how to cope with suicidal thoughts and difficult circumstances, and provide a power_ful reminder that suicide is preventable and suicidal crises can be overcome (panel). (PsycInfo Database Record (c) 2021 APA, all rights reserved)

15.
J Affect Disord ; 282: 991-995, 2021 03 01.
Article in English | MEDLINE | ID: covidwho-1039423

ABSTRACT

BACKGROUND: The COVID-19 pandemic and public health measures necessary to address it may have major effects on mental health, including on self-harm. We have used well-established monitoring systems in two hospitals in England to investigate trends in self-harm presentations to hospitals during the early period of the pandemic. METHOD: Data collected in Oxford and Derby on patients aged 18 years and over who received a psychosocial assessment after presenting to the emergency departments following self-harm were used to compare trends during the three-month period following lockdown in the UK (23rd March 2020) to the period preceding lockdown and the equivalent period in 2019. RESULTS: During the 12 weeks following introduction of lockdown restrictions there was a large reduction in the number of self-harm presentations to hospitals by individuals aged 18 years and over compared to the pre-lockdown weeks in 2020 (mean weekly reduction of 13.5 (95% CI 5.6 - 21.4) and the equivalent period in 2019 (mean weekly reduction of 18.0 (95% CI 13.9 - 22.1). The reduction was greater in females than males, occurred in all age groups, with a larger reduction in presentations following self-poisoning than self-injury. CONCLUSIONS: A substantial decline in hospital presentations for self-harm occurred during the three months following the introduction of lockdown restrictions. Reasons could include a reduction in self-harm at the community level and individuals avoiding presenting to hospital following self-harm. Longer-term monitoring of self-harm behaviour during the pandemic is essential, together with efforts to encourage help-seeking and the modification of care provision.


Subject(s)
COVID-19 , Self-Injurious Behavior , Adolescent , Adult , Communicable Disease Control , Emergency Service, Hospital , England/epidemiology , Female , Hospitals , Humans , Male , Pandemics , SARS-CoV-2 , Self-Injurious Behavior/epidemiology
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