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Cited by 12Suicide and Self-Harm StudiesHomicide, Infanticide, and Child AbuseInjury Epidemiology and Prevention

Near-Fatal Self-Harm Among Canadian Adolescents

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Mitchell, Rachel HB, Ani, Cornelius, Cyr, Claude, Irvine, James, Joffe, Ari R, Skinner, Robin, Wong, Sam, Stang, Antonia S +2 more·2022·The Canadian Journal of Psychiatry
DOI 10.1177/07067437211058602PMC PMC9301146
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Abstract

Objective: To evaluate the clinical features of Canadian adolescents admitted to the intensive care unit (ICU) for medically serious self-harm. Methods: 2700 Canadian paediatricians were surveyed monthly over two years (January 2017 to December 2018) through the Canadian Paediatric Surveillance Program to ascertain data from eligible cases. Results: Ninety-three cases (73 female; age 15.2 ± 1.5) met the case definition. Four provinces reported the majority of cases: Quebec (n = 27), Ontario (n = 26), Alberta (n = 21), and British Columbia (n = 8). There were 10 deaths, 9 by hanging. Overdose and hanging were the most frequently reported methods of self-harm (74.2% and 19.4%, respectively). Overdose was more common in females (80.8% females vs. 50% males; χ 2 = 7.8 (1), p = .005), whereas hanging was more common in males (35% males vs. 15.1% females, χ 2 = 3.9 (1), p = .04). More females than males had a past psychiatric diagnosis (79% vs. 58%; χ 2 = 4.1 (1), p = .06), a previous suicide attempt (55.9% vs. 29.4%, χ 2 = 3.8 (1), p = .05), and prior use of mental health service (69.7% vs. 27.8%, χ 2 = 10.4 (1), p = .001). Family conflict was the most commonly identified precipitating factor (43%) of self-harm. Conclusions: Among Canadian adolescents admitted to the ICU with medically serious self-harm, females demonstrate a higher rate of suicide attempts and prior mental health care engagement, whereas males are more likely to die by suicide. These findings are consistent with data from other adolescent samples, as well as data from working-age and older adults. Therefore, a sex-specific approach to suicide prevention is warranted as part of a national suicide prevention strategy; family conflict may be a specific target for suicide prevention interventions among adolescents.

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  • Parent or family involvement may be an important modification because of the prominent role families have during this developmental stage and the apparent link between family functioning and adolescent SITB.

    “For example, parent or family involvement may be an important modification44 because of the prominent role families have during this developmental stage and the apparent link between family functioning and adolescent SITB.52,53”

    From Safety Planning Interventions for Suicide Prevention in Children and Adolescents (2025) · cites this paper as [52]

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Authors
Mitchell, R. H., Ani, C., Cyr, C., Irvine, J., Joffe, A. R., Skinner, R., Wong, S., Stang, A. S., Laffin, M., & Korczak, D. J.
Affiliations
  • Sunnybrook Health Science Centre (CA)
  • Hammersmith Hospital (GB)
  • Université de Sherbrooke (CA)
  • University of Saskatchewan (CA)
  • University of Alberta (CA)
  • Public Health Agency of Canada (CA)
  • University of Calgary (CA)
  • Canadian Paediatric Surveillance Program, Ottawa, ON, Canada
  • Hospital for Sick Children (CA)
Corresponding author
Korczak, Daphne J
ORCID
Venue
The Canadian Journal of Psychiatry
Publisher
SAGE Publications
Published
2021-11-30
Volume
67
Issue
8
Pages
598-607
ISSN
  • 0706-7437 (ISSN-L)
  • 1497-0015
DOI
10.1177/07067437211058602
PMC
PMC9301146
OpenAlex
W3217212829
Cited by
12
References
13
Citations by year
2026: 2 · 2025: 6 · 2023: 4
FWCI
0.68
Type
journal article
Language
en
Open access
Licence
Locations
  • The Canadian Journal of Psychiatry (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
Funders
  • Public Health Agency of Canada
  • Canadian Pediatric Society
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 › Public Health, Environmental and Occupational Health › Injury Epidemiology and Prevention
Keywords
adolescent self-harm, suicide attempts, intensive care unit admission, hanging, drug overdose, sex differences, family conflict, suicide prevention, psychiatric comorbidity, Canadian adolescents
MeSH terms
Adolescent, Aged, Alberta, Mental Disorders, Child, Female, Humans, Male, Mental Health Services, Suicide, Attempted, Self-Injurious Behavior, Drug Overdose

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