The idea that someone who engages in self-harm would be more likely to commit suicide is not exactly new, but a study from late September suggests that the risk factor could be substantially higher than most realize. Self-harm is also more common than most people think among youth and young adults, so it’s important to understand the kind of events it can lead to later in life, especially if started at a young age.
The study looked at 13,731 patients between ages 18–24 who were hospitalized after a self-harm incident between 1990 and 2003, as well as a control group of 137,310 individuals of the same age. All patients were followed until December 2009, and rates of suicide, psychiatric hospitalization, and use of psychotropic medication were examined in the short term (1–5 years) and long term (6+ years) follow-up periods.
It was found that those who engaged in self-harm had a suicide rate that was 16 times higher than the control group. The researchers also noted that a large portion had ongoing mental health problems—half were being treated with psychotropic medication, and a fifth were undergoing in-patient psychiatric care. This works out to the self-harm group having a six times higher risk of psychiatric hospitalization, and roughly triple the risk of being on psychotropic medication. Patients who were known at the start of the study to have mental illnesses, especially psychotic disorders, and/or a family history of suicide, were also seen to have higher rates of adverse outcomes.
For clarity, it is worth pointing out that this study only compared young people who had been hospitalized for self-harm with those in the general population. It is possible that people who self-harm, but not to the point of hospitalization, would experience different outcomes. Despite this clarification, the significance of the findings remains the same.
It is important for clinicians to be aware of the increased suicide risk that self-harm can indicate. The same goes for family members and friends of a patient as well. Hopefully, these findings can help spur a bit more awareness and action that can get troubled young adults the help that they need.
Beckman, K., et. al., “Mental Illness and suicide after self-harm among young adults: long-term follow-up of self-harm patients, admitted to hospital care, in a national cohort,” Psychological Medicine, 2016; http://dx.doi.org/10.1017/S0033291716002282.