Healthcare contacts with self-harm during COVID-19: An e-cohort whole-population-based study using individual-level linked routine electronic health records in Wales, UK, 2016-March 2021.
<h4>Introduction</h4>Reduced rates of help seeking by those who self-harmed during the COVID-19 pandemic have been reported.<h4>Objectives</h4>To understand changes in healthcare service contacts for self-harm during the COVID-19 pandemic across primary, emergency and seconda...
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| Format: | Article |
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Public Library of Science (PLoS)
2022-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0266967 |
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| author | M DelPozo-Banos S C Lee Y Friedmann A Akbari F Torabi K Lloyd R A Lyons A John |
| author_facet | M DelPozo-Banos S C Lee Y Friedmann A Akbari F Torabi K Lloyd R A Lyons A John |
| author_sort | M DelPozo-Banos |
| collection | DOAJ |
| description | <h4>Introduction</h4>Reduced rates of help seeking by those who self-harmed during the COVID-19 pandemic have been reported.<h4>Objectives</h4>To understand changes in healthcare service contacts for self-harm during the COVID-19 pandemic across primary, emergency and secondary care.<h4>Methods</h4>This retrospective cohort study used routine electronic healthcare data for Wales, United Kingdom, from 2016 to March 14, 2021. Population-based data from primary care, emergency departments and hospital admissions were linked at individual-level. All Welsh residents aged ≥10 years over the study period were included in the study. Primary, emergency and secondary care contacts with self-harm at any time between 2016 and March 14, 2021 were identified. Outcomes were counts, incidence, prevalence and proportion of self-harm contacts relative to all contacts in each and all settings, as well as the proportion of people contacting one or more settings with self-harm. Weekly trends were modelled using generalised estimated equations, with differences between 2020 (to March 2021) and comparison years 2016-2018 (to March 2017-2019) quantified using difference in differences, from which mean rate of odds ratios (μROR) across years was reported.<h4>Results</h4>The study included 3,552,210 individuals over the study period. Self-harm contacts reduced across services in March and December 2020 compared to previous years. Primary care contacts with self-harm reduced disproportionately compared to non-self-harm contacts (μROR = 0.7, p<0.05), while their proportion increased in emergency departments during April 2020 (μROR = 1.3, p<0.05 in 2/3 comparison years) and hospital admissions during April-May 2020 (μROR = 1.2, p<0.05 in 2/3 comparison years). Despite this, those who self-harmed in April 2020 were more likely to be seen in primary care than other settings compared to previous years (μROR = 1.2, p<0.05). A lower proportion of those with self-harm contacts in emergency departments were subsequently admitted to hospital in December 2020 compared to previous years (μROR = 0.5, p<0.05).<h4>Conclusions</h4>These findings suggest that those who self-harmed during the COVID-19 pandemic may have been less likely to seek help, and those who did so faced more stringent criteria for admission. Communications encouraging those who self-harm to seek help during pandemics may be beneficial. However, this needs to be supported by maintained provision of mental health services. |
| format | Article |
| id | doaj-art-6e8b0bab0dd84b9f862068d024a1cd41 |
| institution | Kabale University |
| issn | 1932-6203 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Public Library of Science (PLoS) |
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| spelling | doaj-art-6e8b0bab0dd84b9f862068d024a1cd412025-08-20T03:46:21ZengPublic Library of Science (PLoS)PLoS ONE1932-62032022-01-01174e026696710.1371/journal.pone.0266967Healthcare contacts with self-harm during COVID-19: An e-cohort whole-population-based study using individual-level linked routine electronic health records in Wales, UK, 2016-March 2021.M DelPozo-BanosS C LeeY FriedmannA AkbariF TorabiK LloydR A LyonsA John<h4>Introduction</h4>Reduced rates of help seeking by those who self-harmed during the COVID-19 pandemic have been reported.<h4>Objectives</h4>To understand changes in healthcare service contacts for self-harm during the COVID-19 pandemic across primary, emergency and secondary care.<h4>Methods</h4>This retrospective cohort study used routine electronic healthcare data for Wales, United Kingdom, from 2016 to March 14, 2021. Population-based data from primary care, emergency departments and hospital admissions were linked at individual-level. All Welsh residents aged ≥10 years over the study period were included in the study. Primary, emergency and secondary care contacts with self-harm at any time between 2016 and March 14, 2021 were identified. Outcomes were counts, incidence, prevalence and proportion of self-harm contacts relative to all contacts in each and all settings, as well as the proportion of people contacting one or more settings with self-harm. Weekly trends were modelled using generalised estimated equations, with differences between 2020 (to March 2021) and comparison years 2016-2018 (to March 2017-2019) quantified using difference in differences, from which mean rate of odds ratios (μROR) across years was reported.<h4>Results</h4>The study included 3,552,210 individuals over the study period. Self-harm contacts reduced across services in March and December 2020 compared to previous years. Primary care contacts with self-harm reduced disproportionately compared to non-self-harm contacts (μROR = 0.7, p<0.05), while their proportion increased in emergency departments during April 2020 (μROR = 1.3, p<0.05 in 2/3 comparison years) and hospital admissions during April-May 2020 (μROR = 1.2, p<0.05 in 2/3 comparison years). Despite this, those who self-harmed in April 2020 were more likely to be seen in primary care than other settings compared to previous years (μROR = 1.2, p<0.05). A lower proportion of those with self-harm contacts in emergency departments were subsequently admitted to hospital in December 2020 compared to previous years (μROR = 0.5, p<0.05).<h4>Conclusions</h4>These findings suggest that those who self-harmed during the COVID-19 pandemic may have been less likely to seek help, and those who did so faced more stringent criteria for admission. Communications encouraging those who self-harm to seek help during pandemics may be beneficial. However, this needs to be supported by maintained provision of mental health services.https://doi.org/10.1371/journal.pone.0266967 |
| spellingShingle | M DelPozo-Banos S C Lee Y Friedmann A Akbari F Torabi K Lloyd R A Lyons A John Healthcare contacts with self-harm during COVID-19: An e-cohort whole-population-based study using individual-level linked routine electronic health records in Wales, UK, 2016-March 2021. PLoS ONE |
| title | Healthcare contacts with self-harm during COVID-19: An e-cohort whole-population-based study using individual-level linked routine electronic health records in Wales, UK, 2016-March 2021. |
| title_full | Healthcare contacts with self-harm during COVID-19: An e-cohort whole-population-based study using individual-level linked routine electronic health records in Wales, UK, 2016-March 2021. |
| title_fullStr | Healthcare contacts with self-harm during COVID-19: An e-cohort whole-population-based study using individual-level linked routine electronic health records in Wales, UK, 2016-March 2021. |
| title_full_unstemmed | Healthcare contacts with self-harm during COVID-19: An e-cohort whole-population-based study using individual-level linked routine electronic health records in Wales, UK, 2016-March 2021. |
| title_short | Healthcare contacts with self-harm during COVID-19: An e-cohort whole-population-based study using individual-level linked routine electronic health records in Wales, UK, 2016-March 2021. |
| title_sort | healthcare contacts with self harm during covid 19 an e cohort whole population based study using individual level linked routine electronic health records in wales uk 2016 march 2021 |
| url | https://doi.org/10.1371/journal.pone.0266967 |
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