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Suicide risk following hospital attendance with self-harm: a national cohort study in Ireland

Nature Mental Health volume 1, pages 982–989 (2023)Cite this article

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Abstract

History of self-harm is the strongest predictor of suicide, but there are few national studies that estimate the risk of suicide following self-harm in a clearly defined clinical cohort. Records from the National Self-Harm Registry Ireland between 1 January 2015 and 31 December 2017 (n = 23,764) were linked to national suicide records via the Irish Probable Suicide Deaths Study. The 12-month cumulative incidence of suicide for male, female and all persons was 1.3%, 0.6%, and 0.9%, respectively. Suicide risk was more than 80 times higher in the self-harm cohort relative to the general population. Associated factors included male sex, older age, attempted hanging as a method of self-harm, and self-harm history in the previous 12 months. This national study highlights the greatly elevated risk of suicide mortality following hospital-presenting self-harm. These findings reinforce the need to provide appropriate care and timely interventions for this patient group.

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Fig. 1: Cumulative probability of suicide following self-harm.

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Data availability

As per the conditions of the NSHRI and the IPSDS, data can be shared only on request. Requests to access data from the NSHRI should be made via infonsrf@ucc.ie. For any information on the data used from the IPSDS, contact should be made via info@nosp.ie.

Code availability

Requests to access the underlying code for the analysis in this manuscript can be made via the corresponding author.

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Acknowledgments

We thank S. Lyons and E. Lynn of the Health Research Board for their assistance with the data linkage process. We also thank G. Cox and members of the IPSDS Data and Intelligence Advisory Group for facilitating this work. E.G. is supported by an HRB Emerging Investigator Award (grant number EIA-2019-005). E.A. is supported by an HRB Research Leader Award (grant number IRRL-2015-1586). E.M.McM. is supported by an HRB Applying Research into Policy and Practice Award (grant number ARPP-A-2018-009). The study funders had no role in study design; in the collection, analysis, or interpretation of data; in the writing of the report; or in the decision to submit the paper for publication. The authors had full access to all the data in the study and had final responsibility for the decision to submit for publication.

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Authors and Affiliations

  1. School of Public Health, University College Cork, Cork, Ireland

    E. Griffin, E. Arensman, I. J. Perry & E. M. McMahon

  2. National Suicide Research Foundation, Cork, Ireland

    E. Griffin, P. Corcoran, E. Arensman, K. Kavalidou & E. M. McMahon

  3. Australian Institute for Suicide Research and Prevention, School of Applied Psychology, Griffith University, Brisbane, Australia

    E. Arensman

  4. HSE National Office for Suicide Prevention, Dublin, Ireland

    K. Kavalidou

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  6. E. M. McMahon
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Contributions

E.G., E.M.McM., P.C., E.A. and I.J.P. were responsible for study conception and design. E.G. and P.C. conducted the data analysis. E.G., E.M.McM. and K.K. were responsible for data compilation and data cleaning. E.G. and E.M.McM. drafted the manuscript, which was reviewed by all authors. All authors approved the final version of the manuscript.

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Correspondence to E. Griffin.

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Nature Mental Health thanks Alejandro de la Torre-Luque and the other, anonymous, reviewer(s) for their contribution to the peer review of this work.

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Griffin, E., Corcoran, P., Arensman, E. et al. Suicide risk following hospital attendance with self-harm: a national cohort study in Ireland. Nat. Mental Health 1, 982–989 (2023). https://doi.org/10.1038/s44220-023-00153-6

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