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Cited by 415Suicide and Self-Harm StudiesHomicide, Infanticide, and Child AbuseMental Health Treatment and Access

The DOI matches its Crossref record; 29 of the 29 references it cites were found in a registry or an index.

Prevalence of non-suicidal self-harm and service contact in England, 2000-14: repeated cross-sectional surveys of the general population

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McManus, Sally, Gunnell, David, Cooper, Claudia, Bebbington, Paul E, Howard, Louise M, Brugha, Traolach, Jenkins, Rachel, Hassiotis, Angela, Weich, Scott, Appleby, Louis·2019·The Lancet Psychiatry
DOI 10.1016/s2215-0366(19)30188-9PMC PMC7646286
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Abstract

BACKGROUND: The number of people presenting to hospital emergency departments after self-harming has increased in England. However, most people who self-harm do not present to hospitals, so whether this rise reflects an increase in the prevalence of self-harm in the community is unknown. Also unknown is whether the prevalence of non-suicidal self-harm (NSSH) or suicidal self-harm, or both, has increased. We aimed to establish temporal trends in the prevalence of NSSH in England. METHODS: We analysed data from participants in the 2000 (n=7243), 2007 (n=6444), and 2014 (n=6477) Adult Psychiatric Morbidity Surveys of the general population, selecting those aged 16-74 years and living in England. We used weighted data and controlled for complex survey design. We generated temporal trends in lifetime prevalence and methods of, and motivations for, NSSH, and consequent service contact. We used multiple variable logistic regression analyses to investigate factors associated with service contact. FINDINGS: The prevalence of self-reported lifetime NSSH increased from 2·4% (95% CI 2·0-2·8) in 2000, to 6·4% (5·8-7·2) in 2014. Increases in prevalence were noted in both sexes and across age groups-most notably in women and girls aged 16-24 years, in whom prevalence increased from 6·5% (4·2-10·0) in 2000, to 19·7% (15·7-24·5) in 2014. The proportion of the population reporting NSSH to relieve unpleasant feelings of anger, tension, anxiety, or depression increased from 1·4% (95% CI 1·0-2·0) to 4·0% (3·2-5·0) in men and boys, and from 2·1% (1·6-2·7) to 6·8% (6·0-7·8) in women and girls, between 2000 and 2014. In 2014, 59·4% (95% CI 54·7-63·9) of participants who had engaged in NSSH reported no consequent medical or psychological service contact, compared with 51·2% (42·2-60·0) in 2000 and 51·8% (47·3-56·4) in 2007. Male participants and those aged 16-34 years were less likely to have contact with health services than were female participants and older people. INTERPRETATION: The prevalence of NSSH has increased in England, but resultant service contact remains low. In 2014, about one in five female 16-24-year-olds reported NSSH. There are potential lifelong implications of NSSH, such as an increased frequency of suicide, especially if the behaviours are adopted as a long-term coping strategy. Self-harm needs to be discussed with young people without normalising it. Young people should be offered help by primary care, educational, and other services to find safer ways to deal with emotional stress. FUNDING: NHS Digital, English Department of Health and Social Care, and the National Institute for Health Research.

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Figure 1 Prevalence of non-suicidal self-harm in men and boys (A) and women and girls (B), by age group Data were self-reported in person (ie, face to face). Error bars show the 95% CIs.
Figure 1 Prevalence of non-suicidal self-harm in men and boys (A) and women and girls (B), by age group Data were self-reported in person (ie, face to face). Error bars show the 95% CIs.CC BY · PubMed Central
Figure 2 Method of non-suicidal self-harm reported by men and boys (A) and women and girls (B) aged 16–74 years Error bars show the 95% CIs.
Figure 2 Method of non-suicidal self-harm reported by men and boys (A) and women and girls (B) aged 16–74 years Error bars show the 95% CIs.CC BY · PubMed Central
Figure 3 Reasons for non-suicidal self-harm among men and boys (A) and women and girls (B) aged 16–74 years Error bars show the 95% CIs.
Figure 3 Reasons for non-suicidal self-harm among men and boys (A) and women and girls (B) aged 16–74 years Error bars show the 95% CIs.CC BY · PubMed Central

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Metadata

Authors
McManus, S., Gunnell, D., Cooper, C., Bebbington, P. E., Howard, L. M., Brugha, T., Jenkins, R., Hassiotis, A., Weich, S., & Appleby, L.
Affiliations
  • NatCen Social Research (GB)
  • University Hospitals Bristol NHS Foundation Trust (GB)
  • University College London (GB)
  • King's College London (GB)
  • University of Leicester (GB)
  • University of Sheffield (GB)
  • University of Manchester (GB)
Corresponding author
McManus, Sally
ORCID
Venue
The Lancet Psychiatry
Publisher
Elsevier BV
Published
2019-07
Volume
6
Issue
7
Pages
573-581
ISSN
2215-0366 (ISSN-L)
DOI
10.1016/s2215-0366(19)30188-9
PMC
PMC7646286
OpenAlex
W2948102438
Cited by
415
References
29
Citations by year
2026: 28 · 2025: 61 · 2024: 47 · 2023: 68 · 2022: 64 · 2021: 91 · 2020: 44 · 2019: 12
FWCI
61.61
Type
journal article
Language
en
Open access
Licence
Locations
  • The Lancet Psychiatry (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Research Explorer (The University of Manchester) (publishedVersion, other-oa)
  • Bristol Research (University of Bristol) (publishedVersion, cc-by)
  • White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (acceptedVersion)
  • City Research Online (City University London) (acceptedVersion)
  • UCL Discovery (University College London) (submittedVersion)
  • Figshare (submittedVersion, cc-by)
  • Research Portal (King's College London) (submittedVersion, cc-by)
  • Leicester Research Archive (University of Leicester) (submittedVersion, other-oa)
Funders
  • University Hospitals Bristol NHS Foundation Trust
  • South London and Maudsley NHS Foundation Trust
  • National Institute for Health Research (PHPEHF50/27, 023/0167)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
  • Social Sciences › Sociology and Political Science › Homicide, Infanticide, and Child Abuse
  • Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
Keywords
non-suicidal self-injury, prevalence trends, temporal trends, service contact, mental health service utilization, self-harm methods, suicidal self-harm, young women, gender differences, England, Adult Psychiatric Morbidity Survey, general population, mental health services funding, mental health professionals
MeSH terms
Adolescent, Adult, Aged, Cross-Sectional Studies, Emergency Service, Hospital, England, Female, Humans, Male, Middle Aged, Risk Factors, Prevalence, Self-Injurious Behavior, Age Distribution, Sex Distribution, Young Adult

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