Healthcare contacts with self-harm during COVID-19: An e-cohort whole-population-based study using individual-level linked routine electronic health records in Wales, UK, 2016-March 2021

被引:9
|
作者
DelPozo-Banos, M. [1 ]
Lee, S. C. [1 ]
Friedmann, Y. [1 ]
Akbari, A. [2 ]
Torabi, F. [2 ]
Lloyd, K. [1 ]
Lyons, R. A. [1 ]
John, A. [1 ]
机构
[1] Swansea Univ, Sch Med, Swansea, W Glam, Wales
[2] Swansea Univ, Sch Med, Populat Data Sci, Swansea, W Glam, Wales
来源
PLOS ONE | 2022年 / 17卷 / 04期
基金
英国惠康基金; 英国医学研究理事会; 英国工程与自然科学研究理事会; 英国经济与社会研究理事会;
关键词
MENTAL-HEALTH; UNITED-STATES; SUICIDE; DIFFERENCE; EPISODES; CHILDREN; POLICY;
D O I
10.1371/journal.pone.0266967
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Introduction Reduced rates of help seeking by those who self-harmed during the COVID-19 pandemic have been reported. Objectives To understand changes in healthcare service contacts for self-harm during the COVID-19 pandemic across primary, emergency and secondary care. Methods This retrospective cohort study used routine electronic healthcare data for Wales, United Kingdom, from 2016 to March 14, 2021. Population-based data from primary care, emergency departments and hospital admissions were linked at individual-level. All Welsh residents aged >= 10 years over the study period were included in the study. Primary, emergency and secondary care contacts with self-harm at any time between 2016 and March 14, 2021 were identified. Outcomes were counts, incidence, prevalence and proportion of self-harm contacts relative to all contacts in each and all settings, as well as the proportion of people contacting one or more settings with self-harm. Weekly trends were modelled using generalised estimated equations, with differences between 2020 (to March 2021) and comparison years 2016-2018 (to March 2017-2019) quantified using difference in differences, from which mean rate of odds ratios (mu ROR) across years was reported. Results The study included 3,552,210 individuals over the study period. Self-harm contacts reduced across services in March and December 2020 compared to previous years. Primary care contacts with self-harm reduced disproportionately compared to non-self-harm contacts (mu ROR = 0.7, p<0.05), while their proportion increased in emergency departments during April 2020 (mu ROR = 1.3, p<0.05 in 2/3 comparison years) and hospital admissions during April-May 2020 (mu ROR = 1.2, p<0.05 in 2/3 comparison years). Despite this, those who self-harmed in April 2020 were more likely to be seen in primary care than other settings compared to previous years (mu ROR = 1.2, p<0.05). A lower proportion of those with self-harm contacts in emergency departments were subsequently admitted to hospital in December 2020 compared to previous years (mu ROR = 0.5, p<0.05). Conclusions These findings suggest that those who self-harmed during the COVID-19 pandemic may have been less likely to seek help, and those who did so faced more stringent criteria for admission. Communications encouraging those who self-harm to seek help during pandemics may be beneficial. However, this needs to be supported by maintained provision of mental health services.
引用
收藏
页数:19
相关论文
共 8 条
  • [1] Widening Excess Mortality During the COVID-19 Pandemic in Individuals Who Self-Harmed A Whole-Population-Based E-Cohort Study in Wales, UK, April 2016-March 2021
    Lee, Sze Chim
    DelPozo-Banos, Marcos
    Friedmann, Yasmin
    Akbari, Ashley
    Lyons, Ronan A.
    John, Ann
    [J]. CRISIS-THE JOURNAL OF CRISIS INTERVENTION AND SUICIDE PREVENTION, 2024, 45 (02) : 154 - 158
  • [2] Self-harm presentation across healthcare settings by sex in young people: an e-cohort study using routinely collected linked healthcare data in Wales, UK
    Marchant, Amanda
    Turner, Samantha
    Balbuena, Lloyd
    Peters, Evyn
    Williams, Dave
    Lloyd, Keith
    Lyons, Ronan
    John, Ann
    [J]. ARCHIVES OF DISEASE IN CHILDHOOD, 2020, 105 (04) : 347 - 354
  • [3] Contacts with primary and secondary healthcare prior to suicide: case-control whole-population-based study using person-level linked routine data in Wales, UK, 2000-2017
    John, Ann
    DelPozo-Banos, Marcos
    Gunnell, David
    Dennis, Michael
    Scourfield, Jonathan
    Ford, David, V
    Kapur, Nav
    Lloyd, Keith
    [J]. BRITISH JOURNAL OF PSYCHIATRY, 2020, 217 (06) : 717 - 724
  • [4] Contacts with primary and secondary healthcare before suicide by those under the care of mental health services: case-control, whole-population-based study using person-level linked routine data in Wales, UK during 2000-2015
    DelPozo-Banos, Marcos
    Rodway, Cathryn
    Lee, Sze Chim
    Rouquette, Olivier Y.
    Ibrahim, Saied
    Lloyd, Keith
    Appleby, Louis
    Kapur, Navneet
    John, Ann
    [J]. BJPSYCH OPEN, 2024, 10 (03):
  • [5] Primary care clinical management following self-harm during the first wave of COVID-19 in the UK: population-based cohort study
    Steeg, Sarah
    Carr, Matthew
    Trefan, Laszlo
    Ashcroft, Darren
    Kapur, Navneet
    Nielsen, Emma
    McMillan, Brian
    Webb, Roger
    [J]. BMJ OPEN, 2022, 12 (02):
  • [6] Disordered eating and self-harm as risk factors for poorer mental health during the COVID-19 pandemic: a UK-based birth cohort study
    Naomi Warne
    Jon Heron
    Becky Mars
    Alex S. F. Kwong
    Francesca Solmi
    Rebecca Pearson
    Paul Moran
    Helen Bould
    [J]. Journal of Eating Disorders, 9
  • [7] Disordered eating and self-harm as risk factors for poorer mental health during the COVID-19 pandemic: a UK-based birth cohort study
    Warne, Naomi
    Heron, Jon
    Mars, Becky
    Kwong, Alex S. F.
    Solmi, Francesca
    Pearson, Rebecca
    Moran, Paul
    Bould, Helen
    [J]. JOURNAL OF EATING DISORDERS, 2021, 9 (01)
  • [8] Impact of the Covid-19 pandemic on the frequency of primary care-recorded mental illness and self-harm episodes in the UK: population-based cohort study of 14 million individuals (vol 8, e4, 2021)
    Kapur, N.
    Clements, C.
    Appleby, L.
    [J]. LANCET PSYCHIATRY, 2021, 8 (02): : E9 - E9