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Home > COVID-19 and its effect on emergency presentations to a tertiary hospital with self-harm in Ireland.

McIntyre, A and Tong, K and McMahon, E and Doherty, AM (2020) COVID-19 and its effect on emergency presentations to a tertiary hospital with self-harm in Ireland. Irish Journal of Psychological Medicine , Accepted Version , pp. 1-20. DOI: https://doi.org/10.1017/ipm.2020.116.

OBJECTIVES
This study aimed to assess the impact of COVID-19 on presentations to an acute hospital with self-harm.

METHODS
All presentations to University Hospital Galway with self-harm were assessed during the peak period of the coronavirus crisis in Ireland, over the three months from 1st March to 31st May 2020. These data were compared with presentations in the same months in the three years preceding (2017-2019). Data were obtained from the anonymised service database.

RESULTS
This study found that in 2020, the rate of presentation with self-harm dropped by 35% from March to April and rose by 104% from April to May, peaking from mid-May. When trends over a four-year period were examined, there was a significantly higher lethality of attempt (p<0.001), and significant differences in diagnosis (p=0.031) in 2020 in comparison with the three previous years. The increased lethality of presentations remained significant after age and gender were controlled for (p=0.036). There were also significant differences in the underlying psychiatric diagnoses(p=0.018), notably with a significant increase in substance misuse disorders presenting during the 2020 study period.

CONCLUSIONS
COVID-19 showed a reduction in self-harm presentations initially, followed by a sharp increase in May 2020. If a period of economic instability follows as predicted, it is likely that this will further impact the mental health of the population, along with rates of self-harm and suicidal behaviours. There is a need for research into the longer-term effect of the restrictions and changes due to Covid-19, especially with respect to self-harm.


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