The fifth annual report from the National Registry of Deliberate Self Harm was published in March 2007. The report contains information relating to each episode of deliberate self-harm from persons presenting to all general hospital A&E departments and two of the three paediatric hospital A&E departments in Ireland in 2005. The Registry defines deliberate self-harm as ‘an act with non-fatal outcome in which an individual deliberately initiates a non-habitual behaviour, that without intervention from others will cause self-harm, or deliberately ingests a substance in excess of the prescribed or generally recognised therapeutic dosage, and which is aimed at realising changes that the person desires via the actual or physical consequences’.1 

The report concludes that there were 10,789 presentations of deliberate self-harm, involving 8,594 individuals, to hospital A&E departments in 2005. The number of presentations was 3% lower than in 2004, when there were 11,092 presentations by 8,610 individuals. The age-standardised rate of deliberate self-harm was 198 per 100,000, compared with 201 per 100,000 in 2004, representing a 2% decrease.  The national rate in 2005 was 37% higher among females than among males, at 230 per 100,000 and 167 per 100,000 respectively. Forty-six per cent of all presentations were by persons less than 30 years of age, and 87% by persons less than 50 years of age. The peak age range for females presenting was 15–19 years, at 606 per 100,000. The peak age range for males presenting was 20–24 years, at 392 per 100,000. There was evidence of alcohol consumption in 41% of all episodes of deliberate self-harm. 

Drug overdose was the most common form of deliberate self-harm, representing 76% of all such episodes (7,751 episodes). Overdose rates were higher among females (82%) than among males (67%). On average, 31 tablets were taken in episodes of drug overdose. The total number of tablets taken was known in 80% of cases. Forty-one per cent of all drug overdoses involved a minor tranquilliser, 32% involved paracetamol and 23% involved anti-depressants. 

Self-cutting was the second most common method of deliberate self-harm, representing 21% of all episodes.  In contrast to drug overdoses, self-cutting was more common among males than among females. 

Repetition of deliberate self-harm accounted for 20.5% of all presentations in 2005.  Cutting and attempted hanging were methods of self-harm associated with an increased level of repetition.  

The report recommends the following measures to reduce the incidence of deliberate self-harm:

• a comprehensive mental health awareness campaign to reduce levels of psychiatric and psychological morbidity in the population
• additional resources to support mental health promotion, and specialist mental health services for adolescents aged 15–19 years
• evidence-based interventions targeting persons who repeatedly self-harm
• a mechanism for linking data collected by the Registry with data on suicide mortality to improve understanding of the relationship between deliberate self-harm and the risk of suicide in the future
• extension of the core Registry dataset to support evaluation of progress on actions in the strategy document on suicide prevention, Reach Out.2

1.  National Registry of Deliberate Self Harm Ireland (2007) Annual Report 2005. Cork: National Suicide Research Foundation.

2. HSE, National Suicide Review Group and Department of Health and Children (2005) Reach Out: National Strategy for Action on Suicide Prevention 2005–2014. Dublin: Health Service Executive.