Homeless more likely to self-harm

Homeless people are 30 times more likely to self-harm than those living in fixed residences, according to a new study analysing five years of hospital presentations.

The research found, in addition to homeless people suffering “a disproportionate burden of self-harm”, they were also more likely to have a repeat incident of self-harming within 12 months.

Conducted by Dr Ella Arensman of the National Suicide Research Foundation and colleagues from the Department of Public Health (Cork & Kerry) at Cork’s St Finbarr’s Hospital and the School of Public Health in UCC, the study noted homeless people are significantly more likely to present with self-cutting or attempted drowning, while intentional drug overdose was the most common method of self-harm among both the homeless and fixed residence populations.

Analysing data on self-harm presentations to 34 hospital emergency departments between 2010 and 2014 inclusive, researchers found the age-standardised incidence rate of self-harm was 30 times higher among the homeless, at 5,572 presentations per 100,000, compared with those with a fixed residence (187 presentations per 100,000).

“There have been increases in the prevalence of homelessness in Ireland in recent years, primarily due to supply shortages in housing,” the study said.

“In Ireland, 5% of all hospital presentations of self-harm in 2015 were by residents of homeless hostels or people of no fixed abode.

Although some of these are repeated presentations among the same individuals, this is disproportionately high; visibly homeless individuals comprised 0.1% of the Irish population in the 2016 census.”

There were 58,747 presentations of self-harm in total, including repeat presentations, between 2010 and 2014, of which 3.9% (2,276) were among the homeless.

It said there was a general increase in the percentage of self-harm presentations among the homeless from 2010, at 2.5%, to 2014, when it rose to 4.6%.

Overall, 60.8% of presentations among homeless people were among those living in Dublin City, compared with 15.5% of all presentations among those with a fixed residence, while 13% of presentations among the homeless in that period occurred in Cork City.

Figures show while 10.2% of those in a fixed residence left before admission, the comparable figure among those who were homeless was 16.6%.

Those who were homeless were also more likely to have left without being medically examined and were less than half as likely to be generally admitted.

Homeless people were likely to present at an older age with self-harm.

Those behind the study recommended cross-sectoral changes to health and housing policy to prevent homelessness and enhance access to appropriate care, as well as enhanced training for healthcare and community-based professionals.

The paper, entitled ‘Self-harm among the homeless population in Ireland: A national registry-based study of incidence and associated factors’, is published today in the Journal of Affective Disorders.

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