Barrett, Peter and Griffin, Eve and Corcoran, Paul and O'Mahony, Mary and Arensman, Ella
(2018)
Self-harm among the homeless population in Ireland: a national registry-based study of incidence and associated factors.
Journal of Affective Disorders,
229,
pp. 523-531.
DOI: http://dx.doi.org/10.1016/j.jad.2017.12.040.
Background: Self-harm is a strong predictor of future suicide, but little is known about self-harm among the homeless population. The study aim was to estimate the incidence of self-harm among the homeless population and to assess factors associated with self-harm.
Methods: Data on self-harm presentations to 34 hospital emergency departments in Ireland were collected by the National Self-Harm Registry Ireland (NSHRI). Index presentations between 2010 and 2014 were included for the homeless and fixed residence populations. Incidence rates of self-harm were calculated using NSHRI data and census estimates. Factors associated with self-harm and repeated self-harm were analysed by multivariable-adjusted logistic regression.
Results: The age-standardised incidence rate of self-harm was 30 times higher among the homeless (5572 presentations per 100,000) compared with those with a fixed residence (187 presentations per 100,000). Homeless people had significantly higher odds of being male, presenting with self-cutting (vs. overdose) and having psychiatric admission (vs. general admission). Homeless people had higher odds of self-harm repetition within 12 months (vs. fixed residence). The odds of repetition were significantly increased among homeless who engaged in self-cutting (vs. overdose) and did not receive psychiatric review at index presentation (vs. reviewed).
Limitations: The study only reflects self-harm presenting to hospital, and assumes no change in homelessness status after index presentation. Residual confounding may affect the results.
Conclusion: There is a disproportionate burden of self-harm among the homeless. Targeted preventive actions are warranted.
Publication Type
Irish-related, Article
Intervention Type
Harm reduction, Screening / Assessment
Identification #
DOI: http://dx.doi.org/10.1016/j.jad.2017.12.040
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