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      Adversity, social support and risk of self-harm during the COVID-19 pandemic

      editorial
      Author(s): , PhD, DClinPsych, BBSc, PG-Dip(Psych), MAPS , , MD, FRCPsych
      Publication date (Electronic, collection):
      Publication date (Electronic):
      Journal: BJPsych Open
      Publisher: Cambridge University Press
      Keywords: Self-harm, social deprivation, COVID-19, adversity, loneliness

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          Summary

          Little is known about the degree to which social factors interact with COVID-19-related adversity to increase the risk of self-harm thoughts and behaviours. Using data derived from a UK cohort study, Paul & Fancourt found that loneliness was associated with an increase in the odds of self-harm thoughts and behaviours, whereas high-quality social support protected against self-harm thoughts and behaviours. The authors concluded that it is the quality of social support and interactions, rather than the act of engaging in social interaction per se, that protects against self-harm in the context of adversity. The COVID-19 pandemic may exert longer-lasting effects on population mental health, and continued surveillance of mental health, including self-harm status, will be essential. If accompanied by appropriate measures of the availability and quality of social support, such monitoring could also inform the development of more effective adaptive interventions for those at risk of engaging in self-harm.

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          Most cited references14

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

          Sally McManus, David Gunnell, Claudia Cooper … (2019)
          Summary 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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            Framing Bias: Media in the Distribution of Power

            Robert M. Entman (2007)
            Article 0 comments Cited 105 times – based on 0 reviews     Review now
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              Loneliness as a predictor of suicidal ideation and behaviour: a systematic review and meta-analysis of prospective studies

              Heather McClelland, Jonathan Evans, Rebecca Nowland … (2020)
              Article 0 comments Cited 104 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): BJPsych Open
                Journal ID (iso-abbrev): BJPsych Open
                Journal ID (publisher-id): BJO
                Title: BJPsych Open
                Publisher: Cambridge University Press (Cambridge, UK )
                ISSN (Electronic): 2056-4724
                Publication date (Electronic, collection): July 2022
                Publication date (Electronic): 25 July 2022
                Publication date PMC-release: 25 July 2022
                Volume: 8
                Issue: 4
                Electronic Location Identifier: e141
                Affiliations
                [1]Justice Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne , Australia; and Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia; and Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK; and Melbourne School of Psychological Sciences, University of Melbourne, Australia
                [2]Centre for Academic Mental Health, Department of Population Health Sciences, Bristol Medical School, University of Bristol , UK
                Author notes
                Correspondence: Rohan Borschmann. Email: rohan.borschmann@ 123456unimelb.edu.au
                Author information
                https://orcid.org/0000-0002-0365-7775
                https://orcid.org/0000-0002-9257-8699
                Article
                Publisher Item ID: S2056472422005531
                DOI: 10.1192/bjo.2022.553
                PMC ID: 9314317
                PubMed ID: 35876072
                SO-VID: ecd5e987-7adf-45d3-b9cb-c6bc3477889b
                Copyright © © The Author(s) 2022
                License:

                This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.

                History
                Date received : 15 February 2022
                Date revision received : 22 June 2022
                Date accepted : 05 July 2022
                Page count
                References: 14, Pages: 2
                Categories
                Subject: Editorial
                Subject: General Adult

                Keywords: self-harm,social deprivation,covid-19,adversity,loneliness
                Data availability:
                Keywords: self-harm, social deprivation, covid-19, adversity, loneliness

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