Evidence map›Paper›PMID 35317881›Full record

ArticleBJPsych open2022

Self-harm in people experiencing homelessness: investigation of incidence, characteristics and outcomes using data from the Multicentre Study of Self-Harm in England.

Caroline Clements, Bushra Farooq, Keith Hawton, Galit Geulayov, Deborah Casey, Keith Waters, Jennifer Ness, Anita Patel, Ellen Townsend, Louis Appleby and 1 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BJPsych open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Caroline ClementsCentre for Mental Health and Safety, School of Health Sciences, Manchester Academic Health Science Centre, University of Manchester, UK.ORCID https://orcid.org/0000-0003-4735-6728
Bushra FarooqCentre for Mental Health and Safety, School of Health Sciences, Manchester Academic Health Science Centre, University of Manchester, UK.
Keith HawtonCentre for Suicide Research, Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK.
Galit GeulayovCentre for Suicide Research, Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK.ORCID https://orcid.org/0000-0002-4093-5156
Deborah CaseyCentre for Suicide Research, Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK.
Keith WatersCentre for Self-harm and Suicide Prevention Research, Derbyshire Healthcare NHS Foundation Trust, Derby, UK.
Jennifer NessCentre for Self-harm and Suicide Prevention Research, Derbyshire Healthcare NHS Foundation Trust, Derby, UK.
Anita PatelCentre for Self-harm and Suicide Prevention Research, Derbyshire Healthcare NHS Foundation Trust, Derby, UK.
Ellen TownsendSelf-Harm Research Group, School of Psychology, University of Nottingham, UK.
Louis ApplebyCentre for Mental Health and Safety, School of Health Sciences, Manchester Academic Health Science Centre, University of Manchester, UK.
Navneet KapurCentre for Mental Health and Safety, School of Health Sciences, Manchester Academic Health Science Centre, University of Manchester, UK; and Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK; and National Institute for Health Research (NIHR) Greater Manchester Patient Safety Translational Research Centre, Manchester, UK.ORCID https://orcid.org/0000-0002-3100-3234

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPeople who experience homelessness are thought to be at high risk of suicide, but little is known about self-harm in this population.

aimsTo examine characteristics and outcomes in people experiencing homelessness who presented to hospital following self-harm.

methodData were collected via specialist assessments and/or hospital patient records from emergency departments in Manchester, Oxford and Derby, UK. Data were collected from 1 January 2000 to 31 December 2016, with mortality follow-up via data linkage with NHS Digital to 31 December 2019. Trend tests estimated change in self-harm over time; descriptive statistics described characteristics associated with self-harm. Twelve-month repetition and long-term mortality were analysed using Cox proportional hazards models and controlled for age and gender.

resultsThere were 4841 self-harm presentations by 3270 people identified as homeless during the study period. Presentations increased after 2010 (IRR = 1.09, 95% CI 1.04-1.14, P < 0.001). People who experienced homelessness were more often men, White, aged under 54 years, with a history of previous self-harm and contact with psychiatric services. Risk of repetition was higher than in domiciled people (HR = 2.05, 95% CI 1.94-2.17, P < 0.001), as were all-cause mortality (HR = 1.45, 95% CI 1.32-1.59. P < 0.001) and mortality due to accidental causes (HR = 2.93, 95% CI 2.41-3.57, P < 0.001).

conclusionsPeople who self-harm and experience homelessness have more complex needs and worse outcomes than those who are domiciled. Emergency department contact presents an opportunity to engage people experiencing homelessness with mental health, drug and alcohol, medical and housing services, as well as other sources of support.

Indexed as

emergency departmentepidemiologyhomelessnessSelf-harmsuicide

Identifiers

PMID35317881
PMCPMC9059614

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.