Queen's University Belfast

Academic Institute

Economic and Social Research Council

Yes

E094

Self-Harm and suicide ideation (i.e. thoughts about dying by suicide) are two of the most important known risk factors for death by suicide. Increasing suicide rates are a major public health concern and Northern Ireland consistently has the highest rate of suicide in the UK and Ireland. Recent policies to reduce the rates of suicide are now including a focus on reducing self-harm and suicide ideation as these are known precursors to suicide. However, little is known about the causes of self-harm or suicide ideation, how these two factors are related and what impact they have on mortality risk either individually or in combination. Understanding the individual level, household-level, area-level and health related predictors for self-harm, ideation and suicide is of vital public health importance so that intervention services can be targeted accurately. Northern Ireland is unique in that it has a national Registry of Self-Harm that has collated information on all presentations to emergency departments for self-harm and self-harm / suicide ideation since 2008 (approximately 8,000 per/year) and the research team has secured access to these data from the data custodians in each of the five Health and Social Care Trusts. The proposed project will link these data to primary care registration data, prescription medication data, hospitalisation data, geographical and death data to better understand the antecedents to and outcomes of self-harm and self-harm / suicide ideation, including mortality risk. Trend analysis will explore trends in self-harm and ideation and associated risk over the last 15 years as well as model potential future trends. Lastly the project will attempt to evaluate the self-harm intervention programme (SHIP), making use of a natural experiment design as SHIP was initiated in the Western Trust before being rolled out in the other four Trusts in 2015. The findings from this project will help identify individuals most at risk and target effective interventions to improve outcomes post self-harm / ideation and reduce suicide risk.

Understanding the determinants of death by suicide, and of ways to protect against suicide, is imperative to public health and is at the core of the Protect Life 2 strategy. The findings of this study will provide policy makers and service providers with the tools to identify, highlight and target populations who would benefit most from interventions through (i) the identification of individuals most at risk of self-harm / ideation and subsequent mortality, and (ii) the examination of the impact of the SHIP on mortality and recidivism – this would inform recommendations on the future of the specialist service based on its efficacy to date.

13/03/2024

TRE