Admission to a UK Major Trauma Centre following deliberate self-harm and attempted suicide: Prevalence and outcomes

Abstract

Background

The incidence of suicide is increasing and for every suicide many more attempt it. Exploring such admissions to UK Major Trauma Centres improves our understanding.

Methods

Data on admissions to the Leeds Major Trauma Centre (2013–2016) following suicide attempts and acts of deliberate self-harm were obtained from the Trauma Audit and Research Network database. Retrospectively, quantitative and qualitative analyses were used to explore frequency of admissions, demographics, mechanism and severity of injury, outcomes, and input from the Clinical Psychology and Liaison Psychiatry services.

Results

A total of 192 admissions were identified; average age was 38.5 (SD: 16.1, range: 11–93), and 72% were male. The most frequent mechanism of injury was ‘fall/jump’ (41%, n = 78). A significant effect was found for gender and mechanism of injury (p = 0.025) with males using a wider range of methods, and females choosing ‘fall/jump’ most frequently. A total of 114 patients (59%) had an injury severity score >15. The suicide attempt was fatal for 34 patients (18%). A significant effect for mechanism of injury and mortality was found, with hanging most frequently, and stabbing least likely, to be fatal (p = 0.001). Twenty-six patients (13.5%) were seen by Clinical Psychology. In 2016, 82% of admissions (n = 37) were seen by Liaison Psychiatry with 33 referred onto other services. Eighteen (53%) had pre-existing mental health difficulties and/or evidence of substance misuse; 14 (38%) were recorded to have one or more previous suicide attempt. Average length of hospital stay was 15.2 days (SD: 26.8, range: 1–284) and the average cost £2958 (range: £195–£55,266). The average number of days in critical care was 2.9 (SD: 5.4, range: 0–29).

Conclusions

This study increased our understanding of deliberate self-harm/suicide attempts in the Leeds Major Trauma Centre. It indicated the high cost of deliberate self-harm/suicide attempts with the majority of patients having high injury severity score, and most surviving. Further research into follow-up and preventative support for this group of patients would be beneficial.

Keywords

Major trauma suicide deliberate self-harm mental health

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