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Children and adolescents who present to hospital following self-harm have an increased future risk of suicide compared with other children and adolescents, which may persist for several years, according to an observational study of more than 9,000 children and adolescents aged 10-18 years who presented to five English hospitals for non-fatal self-harm.

Image of a young person talking to a therapist.

Self-harm is the most important risk factor for subsequent suicide in young people. In the UK, suicide is the leading cause of death in people aged 15–24 years, and general population rates of suicide have increased among people aged 10–19 years since 2010.

This new study, Mortality in children and adolescents following presentation to hospital after non-fatal self-harm in the Multicentre Study of Self-harm: a prospective observational cohort study, is published in The Lancet Child & Adolescent Health journal. Spanning 16 years the study looked at the future risk and cause of death in 9,173 children and adolescents who presented for self-harm, of which 55 (0.6 percent) died by suicide.

While suicide was uncommon, the findings suggest that the annual rate of suicide in the patients who self-harmed was more than 30 times that expected in other young people in the general population. The increased risk remained at a similar level over more than 10 years of follow up.

 

Our findings emphasise a need to identify strategies to try to prevent self-harm in children and adolescents in order to reduce future risk of suicide. They also underline the importance of provision of good care for children and adolescents who present to hospital following self-harm.Professor Keith Hawton, Director of the Centre for Suicide Research, University of Oxford

 

The study included patients from five hospitals (one in Oxford, three in Manchester and one in Derby). The authors note that since most young people who self-harm do not attend a hospital, these findings only relate to those adolescents who do, there tends to be large differences in the patterns of self-harm between the two groups.

Mortality in children and adolescents following presentation to hospital after non-fatal self-harm in the Multicentre Study of Self-harm: a prospective observational cohort study

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