Rates of self-harm did not increase between 2020 and 2021 contrary to pandemic fears

The report from the National Self-Harm Registry of Ireland found there was “ a slight increase” in the proportion of people coming to hospitals on repeat visits due to self-harm during 2021. File photo

Rates of self-harm did not increase between 2020 and 2021, new data shows contrary to fears early in the pandemic, but analysts called for more services to support people who repeatedly self-harm.

National Self-Harm Registry of Ireland manager, Dr Mary Joyce, said their finding of no increase in rates over the first two years of the pandemic is “reassuring”.

The registry reported on Wednesday that in 2021 some 12,661 self-harm presentations were made to hospitals by 9,533 people. The rate of people presenting to hospital following self-harm in 2021 was 196 per 100,000, similar to the rate of 200 per 100,000 reported in 2020.

In line with a pattern seen over the last 20 years, the highest rates of self-harm were recorded among young people.

Among young women, the highest rate was for teens aged 15 to 19 at 888 per 100,000. Among young men, the highest rate is for men aged 20 to 24 at 387 per 100,000.

For men, this is a return to an age pattern seen before the pandemic but different to 2020 when the highest rate was among men aged 25 to 29.

Dr Joyce cautioned: “It will be important to continue to monitor and evaluate the incidence of suicide and self-harm in subsequent years and post-pandemic.

The consequences of economic disruption on suicidal behaviour are of particular concern given existing evidence for increases in suicidal behaviour during economic recessionary times. 

The data on self-harm rates among patients coming to hospitals is, according to the registry, “contrary to early concerns and expectations of a potential increase in self-harm and suicidal behaviours during the pandemic and statements in the media”.

The findings “demonstrate the importance of ongoing surveillance to monitor the potential impact of the pandemic on these behaviours".

“The use of registry data is fundamental in addressing misinformation, in particular during public health emergencies.” 

Mental health

Despite these findings, the data does indicate links between the lockdowns and mental health.

For example, the report found: “On the first day of easing of Level 5 restrictions on April 12 one of the highest daily numbers of self-harm presentations in 2021 was recorded.” 

Hospitals reported lower-than-expected levels of self-harm presentations during January 2021 — some 17% lower — but rates increased again as the lockdown continued.

Dr Joyce also said there was “a slight increase” in the proportion of people coming to hospitals on repeat visits due to self-harm during 2021. The report shows repeat visits rose to 25% in 2021 from 24% during 2020. 

Among all people who presented to hospital with self-harm during 2021 (8,595), some 15.5% (1,334) made at least one repeat presentation during the calendar year, while at least five self-harm presentations were made by 1.9%, or 164 individuals, of all self-harm patients.

“These findings highlight the need to further develop mental health services and supports in Ireland for individuals engaging in self-harm, particularly vulnerable groups such as those who are homeless,” she said.

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“This is of particular importance given the record levels of homelessness and migration in Ireland and other countries.” 

The services which need expansion include “outpatient and inpatient mental health services” particularly those supporting vulnerable groups, the report indicates.

The registry also recommends an increase in early intervention and prevention measures, as well as awareness campaigns around safe sales of paracetamol.

The National Self-Harm Registry Ireland Report 2021 can be read on the Registry website.

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