Deliberate self-harm (DSH) is strongly associated with an increased risk of suicide: a leading cause of premature mortality worldwide and the second leading cause of death among Canadian youth. DSH is also a major public health problem in its own right; it is related to both psychosocial problems in the individual and health service use. DSH is particularly common in teens, where emergency department (ED) presentation rates are more than double the overall rate.
This study will quantify the proportion of ED use by children and adolescents (12-17 year-olds) that is related to DSH. By ascertaining their ED presentations from the age of 12, it will create a cohort of those making their first-ever DSH presentation. This inception cohort will provide unprecedented data on the health service patterns of these young people. It will also be used to provide information on factors associated with repeat DSH presentations, including an analysis of the effect of physician follow-up.
These results will form a comprehensive picture of child and adolescent DSH in the emergency department, including the burden and the opportunities for early intervention. Methodologically, this research also represents a novel application of a statistical technique (hurdle models), which, unlike most previous DSH research, will incorporate analysis of multiple repetition.
