Self-harm and life problems: findings from the Multicentre Study of Self-harm in England.
PURPOSE
Self-harm is a major clinical problem and is strongly linked to suicide. It is important to understand the problems faced by those who self-harm to design effective clinical services and suicide prevention strategies. We investigated the life problems experienced by patients presenting to general hospitals for self-harm.


METHODS
Data for 2000-2010 from the Multicentre Study of Self-harm in England were used to investigate life problems associated with self-harm and their relationship to patient and clinical characteristics, including age, gender, repeat self-harm and employment status.


RESULTS
Of 24,598 patients (36,431 assessed episodes), 57% were female and with a mean age of 33.1 years (SD 14.0 years), 92.6% were identified as having at least one contributing life problem. The most frequently reported problems at first episode of self-harm within the study period were relationship difficulties (especially with partners). Mental health issues and problems with alcohol were also very common (especially in those aged 35-54 years, and those who repeated self-harm). Those who repeated self-harm were more likely to report problems with housing, mental health and dealing with the consequences of abuse.


CONCLUSIONS
Self-harm usually occurs in the context of multiple life problems. Clinical services for self-harm patients should have access to appropriate care for provision of help for relationship difficulties and problems concerning alcohol and mental health issues. Individualised clinical support (e.g. psychological therapy, interventions for alcohol problems and relationship counselling) for self-harm patients facing these life problems may play a crucial role in suicide prevention.
['Townsend|Ellen|E|', 'Ness|Jennifer|J|', 'Waters|Keith|K|', 'Kapur|Navneet|N|', 'Turnbull|Pauline|P|', 'Cooper|Jayne|J|', 'Bergen|Helen|H|', 'Hawton|Keith|K|']
D000293:Adolescent D000328:Adult D000368:Aged D000369:Aged, 80 and over D000437:Alcoholism D004651:Employment D004739:England D005260:Female D006798:Housing D006801:Humans D007398:Interpersonal Relations D008297:Male D001523:Mental Disorders D008875:Middle Aged D000066550:Physical Abuse D012307:Risk Factors D016728:Self-Injurious Behavior D013405:Suicide D055815:Young Adult
Self-harm Life problems Age Gender Repetition