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The impact of the COVID-19 pandemic on presentations to health services following self-harm: systematic review

Sarah Steeg Orcid Logo, Ann John Orcid Logo, David J. Gunnell, Nav Kapur Orcid Logo, Dana Dekel Orcid Logo, Lena Schmidt, Duleeka Knipe Orcid Logo, Ella Arensman, Keith Hawton, Julian P. T. Higgins, Emily Eyles, Catherine Macleod-Hall, Luke A. McGuiness, Roger T. Webb

The British Journal of Psychiatry, Volume: 221, Issue: 4, Pages: 1 - 10

Swansea University Authors: Ann John Orcid Logo, Dana Dekel Orcid Logo

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DOI (Published version): 10.1192/bjp.2022.79

Abstract

BackgroundEvidence on the impact of the pandemic on healthcare presentations for self-harm has accumulated rapidly. However, existing reviews do not include studies published beyond 2020.AimsTo systematically review evidence on presentations to health services following self-harm during the COVID-19...

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Published in: The British Journal of Psychiatry
ISSN: 0007-1250 1472-1465
Published: Royal College of Psychiatrists 2022
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URI: https://cronfa.swan.ac.uk/Record/cronfa60523
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fullrecord <?xml version="1.0"?><rfc1807><datestamp>2023-03-02T14:20:27.0798342</datestamp><bib-version>v2</bib-version><id>60523</id><entry>2022-07-18</entry><title>The impact of the COVID-19 pandemic on presentations to health services following self-harm: systematic review</title><swanseaauthors><author><sid>ed8a9c37bd7b7235b762d941ef18ee55</sid><ORCID>0000-0002-5657-6995</ORCID><firstname>Ann</firstname><surname>John</surname><name>Ann John</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>7904c581b4da2217c348434c9f04f165</sid><ORCID>0000-0003-0137-5149</ORCID><firstname>Dana</firstname><surname>Dekel</surname><name>Dana Dekel</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2022-07-18</date><deptcode>HDAT</deptcode><abstract>BackgroundEvidence on the impact of the pandemic on healthcare presentations for self-harm has accumulated rapidly. However, existing reviews do not include studies published beyond 2020.AimsTo systematically review evidence on presentations to health services following self-harm during the COVID-19 pandemic.MethodA comprehensive search of databases (WHO COVID-19 database; Medline; medRxiv; Scopus; PsyRxiv; SocArXiv; bioRxiv; COVID-19 Open Research Dataset, PubMed) was conducted. Studies published from 1 January 2020 to 7 September 2021 were included. Study quality was assessed with a critical appraisal tool.ResultsFifty-one studies were included: 57% (29/51) were rated as &#x2018;low&#x2019; quality, 31% (16/51) as &#x2018;moderate&#x2019; and 12% (6/51) as &#x2018;high-moderate&#x2019;. Most evidence (84%, 43/51) was from high-income countries. A total of 47% (24/51) of studies reported reductions in presentation frequency, including all six rated as high-moderate quality, which reported reductions of 17&#x2013;56%. Settings treating higher lethality self-harm were overrepresented among studies reporting increased demand. Two of the three higher-quality studies including study observation months from 2021 reported reductions in self-harm presentations. Evidence from 2021 suggests increased numbers of presentations among adolescents, particularly girls.ConclusionsSustained reductions in numbers of self-harm presentations were seen into the first half of 2021, although this evidence is based on a relatively small number of higher-quality studies. Evidence from low- and middle-income countries is lacking. Increased numbers of presentations among adolescents, particularly girls, into 2021 is concerning. Findings may reflect changes in thresholds for help-seeking, use of alternative sources of support and variable effects of the pandemic across groups.</abstract><type>Journal Article</type><journal>The British Journal of Psychiatry</journal><volume>221</volume><journalNumber>4</journalNumber><paginationStart>1</paginationStart><paginationEnd>10</paginationEnd><publisher>Royal College of Psychiatrists</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint>0007-1250</issnPrint><issnElectronic>1472-1465</issnElectronic><keywords>Epidemiology; self-harm; primary care; suicide; COVID-19</keywords><publishedDay>11</publishedDay><publishedMonth>7</publishedMonth><publishedYear>2022</publishedYear><publishedDate>2022-07-11</publishedDate><doi>10.1192/bjp.2022.79</doi><url/><notes/><college>COLLEGE NANME</college><department>Health Data Science</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>HDAT</DepartmentCode><institution>Swansea University</institution><apcterm/><funders>S.S. is funded by a University of Manchester Presidential Fellowship. N.K. and R.T.W. are funded by the National Institute for Health and Care Research (NIHR) Greater Manchester Patient Safety Translational Research Centre (GM PSTRC) at the Northern Care Alliance NHS Foundation Trust and the University of Manchester (grant no. PSTRC-2016-003). J.P.T.H. is an NIHR Senior Investigator (grant nos., until March 2022: NF-SI-0617-10145; from April 2022: NIHR203807). D.J.G. and J.P.T.H. are both are supported by the NIHR Bristol Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol (grant no. BRC-1215-20011). J.P.T.H. and E.E. are supported by the NIHR Applied Research Collaboration West (ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol (grant no. NIHR200181). D.K. was supported by the Wellcome Trust through an Institutional Strategic Support Fund Award to the Elizabeth Blackwell Institute for Health Research, University of Bristol (grant no. 204813/Z/16/Z).</funders><projectreference/><lastEdited>2023-03-02T14:20:27.0798342</lastEdited><Created>2022-07-18T14:17:11.0769756</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Medicine</level></path><authors><author><firstname>Sarah</firstname><surname>Steeg</surname><orcid>0000-0002-7935-1414</orcid><order>1</order></author><author><firstname>Ann</firstname><surname>John</surname><orcid>0000-0002-5657-6995</orcid><order>2</order></author><author><firstname>David J.</firstname><surname>Gunnell</surname><order>3</order></author><author><firstname>Nav</firstname><surname>Kapur</surname><orcid>0000-0002-3100-3234</orcid><order>4</order></author><author><firstname>Dana</firstname><surname>Dekel</surname><orcid>0000-0003-0137-5149</orcid><order>5</order></author><author><firstname>Lena</firstname><surname>Schmidt</surname><order>6</order></author><author><firstname>Duleeka</firstname><surname>Knipe</surname><orcid>0000-0002-1040-7635</orcid><order>7</order></author><author><firstname>Ella</firstname><surname>Arensman</surname><order>8</order></author><author><firstname>Keith</firstname><surname>Hawton</surname><order>9</order></author><author><firstname>Julian P. T.</firstname><surname>Higgins</surname><order>10</order></author><author><firstname>Emily</firstname><surname>Eyles</surname><order>11</order></author><author><firstname>Catherine</firstname><surname>Macleod-Hall</surname><order>12</order></author><author><firstname>Luke A.</firstname><surname>McGuiness</surname><order>13</order></author><author><firstname>Roger T.</firstname><surname>Webb</surname><order>14</order></author></authors><documents><document><filename>60523__24630__ce4adee87f944608b40edc61cd2b8961.pdf</filename><originalFilename>60523.pdf</originalFilename><uploaded>2022-07-19T10:51:28.6539052</uploaded><type>Output</type><contentLength>633742</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>&#xA9; The Author(s), 2022. 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spelling 2023-03-02T14:20:27.0798342 v2 60523 2022-07-18 The impact of the COVID-19 pandemic on presentations to health services following self-harm: systematic review ed8a9c37bd7b7235b762d941ef18ee55 0000-0002-5657-6995 Ann John Ann John true false 7904c581b4da2217c348434c9f04f165 0000-0003-0137-5149 Dana Dekel Dana Dekel true false 2022-07-18 HDAT BackgroundEvidence on the impact of the pandemic on healthcare presentations for self-harm has accumulated rapidly. However, existing reviews do not include studies published beyond 2020.AimsTo systematically review evidence on presentations to health services following self-harm during the COVID-19 pandemic.MethodA comprehensive search of databases (WHO COVID-19 database; Medline; medRxiv; Scopus; PsyRxiv; SocArXiv; bioRxiv; COVID-19 Open Research Dataset, PubMed) was conducted. Studies published from 1 January 2020 to 7 September 2021 were included. Study quality was assessed with a critical appraisal tool.ResultsFifty-one studies were included: 57% (29/51) were rated as ‘low’ quality, 31% (16/51) as ‘moderate’ and 12% (6/51) as ‘high-moderate’. Most evidence (84%, 43/51) was from high-income countries. A total of 47% (24/51) of studies reported reductions in presentation frequency, including all six 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 three higher-quality studies including study observation months from 2021 reported reductions in self-harm presentations. Evidence from 2021 suggests increased numbers of presentations among adolescents, particularly girls.ConclusionsSustained reductions in numbers of self-harm presentations were seen into the first half of 2021, although this evidence is based on a relatively small number of higher-quality studies. Evidence from low- and middle-income countries is lacking. Increased numbers of presentations among adolescents, particularly girls, into 2021 is concerning. Findings may reflect changes in thresholds for help-seeking, use of alternative sources of support and variable effects of the pandemic across groups. Journal Article The British Journal of Psychiatry 221 4 1 10 Royal College of Psychiatrists 0007-1250 1472-1465 Epidemiology; self-harm; primary care; suicide; COVID-19 11 7 2022 2022-07-11 10.1192/bjp.2022.79 COLLEGE NANME Health Data Science COLLEGE CODE HDAT Swansea University S.S. is funded by a University of Manchester Presidential Fellowship. N.K. and R.T.W. are funded by the National Institute for Health and Care Research (NIHR) Greater Manchester Patient Safety Translational Research Centre (GM PSTRC) at the Northern Care Alliance NHS Foundation Trust and the University of Manchester (grant no. PSTRC-2016-003). J.P.T.H. is an NIHR Senior Investigator (grant nos., until March 2022: NF-SI-0617-10145; from April 2022: NIHR203807). D.J.G. and J.P.T.H. are both are supported by the NIHR Bristol Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol (grant no. BRC-1215-20011). J.P.T.H. and E.E. are supported by the NIHR Applied Research Collaboration West (ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol (grant no. NIHR200181). D.K. was supported by the Wellcome Trust through an Institutional Strategic Support Fund Award to the Elizabeth Blackwell Institute for Health Research, University of Bristol (grant no. 204813/Z/16/Z). 2023-03-02T14:20:27.0798342 2022-07-18T14:17:11.0769756 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Sarah Steeg 0000-0002-7935-1414 1 Ann John 0000-0002-5657-6995 2 David J. Gunnell 3 Nav Kapur 0000-0002-3100-3234 4 Dana Dekel 0000-0003-0137-5149 5 Lena Schmidt 6 Duleeka Knipe 0000-0002-1040-7635 7 Ella Arensman 8 Keith Hawton 9 Julian P. T. Higgins 10 Emily Eyles 11 Catherine Macleod-Hall 12 Luke A. McGuiness 13 Roger T. Webb 14 60523__24630__ce4adee87f944608b40edc61cd2b8961.pdf 60523.pdf 2022-07-19T10:51:28.6539052 Output 633742 application/pdf Version of Record true © The Author(s), 2022. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence. true eng https://creativecommons.org/licenses/by/4.0/
title The impact of the COVID-19 pandemic on presentations to health services following self-harm: systematic review
spellingShingle The impact of the COVID-19 pandemic on presentations to health services following self-harm: systematic review
Ann John
Dana Dekel
title_short The impact of the COVID-19 pandemic on presentations to health services following self-harm: systematic review
title_full The impact of the COVID-19 pandemic on presentations to health services following self-harm: systematic review
title_fullStr The impact of the COVID-19 pandemic on presentations to health services following self-harm: systematic review
title_full_unstemmed The impact of the COVID-19 pandemic on presentations to health services following self-harm: systematic review
title_sort The impact of the COVID-19 pandemic on presentations to health services following self-harm: systematic review
author_id_str_mv ed8a9c37bd7b7235b762d941ef18ee55
7904c581b4da2217c348434c9f04f165
author_id_fullname_str_mv ed8a9c37bd7b7235b762d941ef18ee55_***_Ann John
7904c581b4da2217c348434c9f04f165_***_Dana Dekel
author Ann John
Dana Dekel
author2 Sarah Steeg
Ann John
David J. Gunnell
Nav Kapur
Dana Dekel
Lena Schmidt
Duleeka Knipe
Ella Arensman
Keith Hawton
Julian P. T. Higgins
Emily Eyles
Catherine Macleod-Hall
Luke A. McGuiness
Roger T. Webb
format Journal article
container_title The British Journal of Psychiatry
container_volume 221
container_issue 4
container_start_page 1
publishDate 2022
institution Swansea University
issn 0007-1250
1472-1465
doi_str_mv 10.1192/bjp.2022.79
publisher Royal College of Psychiatrists
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
document_store_str 1
active_str 0
description BackgroundEvidence on the impact of the pandemic on healthcare presentations for self-harm has accumulated rapidly. However, existing reviews do not include studies published beyond 2020.AimsTo systematically review evidence on presentations to health services following self-harm during the COVID-19 pandemic.MethodA comprehensive search of databases (WHO COVID-19 database; Medline; medRxiv; Scopus; PsyRxiv; SocArXiv; bioRxiv; COVID-19 Open Research Dataset, PubMed) was conducted. Studies published from 1 January 2020 to 7 September 2021 were included. Study quality was assessed with a critical appraisal tool.ResultsFifty-one studies were included: 57% (29/51) were rated as ‘low’ quality, 31% (16/51) as ‘moderate’ and 12% (6/51) as ‘high-moderate’. Most evidence (84%, 43/51) was from high-income countries. A total of 47% (24/51) of studies reported reductions in presentation frequency, including all six 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 three higher-quality studies including study observation months from 2021 reported reductions in self-harm presentations. Evidence from 2021 suggests increased numbers of presentations among adolescents, particularly girls.ConclusionsSustained reductions in numbers of self-harm presentations were seen into the first half of 2021, although this evidence is based on a relatively small number of higher-quality studies. Evidence from low- and middle-income countries is lacking. Increased numbers of presentations among adolescents, particularly girls, into 2021 is concerning. Findings may reflect changes in thresholds for help-seeking, use of alternative sources of support and variable effects of the pandemic across groups.
published_date 2022-07-11T04:18:42Z
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