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Widening Excess Mortality During the COVID-19 Pandemic in Individuals Who Self-Harmed

Sze Chim Lee, Marcos del Pozo Banos Orcid Logo, Yasmin Friedmann, Ashley Akbari Orcid Logo, Ronan Lyons Orcid Logo, Ann John Orcid Logo

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Swansea University Authors: Sze Chim Lee, Marcos del Pozo Banos Orcid Logo, Yasmin Friedmann, Ashley Akbari Orcid Logo, Ronan Lyons Orcid Logo, Ann John Orcid Logo

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DOI (Published version): 10.1027/0227-5910/a000882

Abstract

BackgroundStudies on COVID-19 pandemic-associated changes in mortality following self-harm remain scarce and inconclusive.AimsTo compare mortality risks in individuals’ who had self-harmed to those who had not, before and during the COVID-19 pandemic (Waves 1 and 2) in Wales, United Kingdom, using p...

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Published in: Crisis
ISSN: 0227-5910 2151-2396
Published: Hogrefe Publishing Group 2022
Online Access: Check full text

URI: https://cronfa.swan.ac.uk/Record/cronfa60486
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Abstract: BackgroundStudies on COVID-19 pandemic-associated changes in mortality following self-harm remain scarce and inconclusive.AimsTo compare mortality risks in individuals’ who had self-harmed to those who had not, before and during the COVID-19 pandemic (Waves 1 and 2) in Wales, United Kingdom, using population-based routinely collected data.MethodWe linked whole population health data to all-cause mortality following an episode of self-harm between April 2016 and March 2021. Propensity score matching, Cox regression, and difference-in-differences were applied to compute changes in excess mortality (as ratios of hazard ratios, RHR) before and during the pandemic for individuals who self-harmed.ResultsThe difference in mortality for individuals who self-harmed compared to those who did not widened during Wave 1 (RHR = 2.0, 95% CI: 1.0-4.0) and Wave 2 (RHR = 2.2, 95% CI: 1.1-4.3) from before the pandemic. Stratification by sex and age group produced no significant subgroup differences although risk for <65 years group were higher. LimitationsLimitations include small sample size and incomplete data on cause-specific deaths during the pandemic. ConclusionOur results underscore continuous monitoring of mortality of individuals who self-harm and effective interventions to address any increases in mortality.
College: Faculty of Medicine, Health and Life Sciences
Funders: This work was supported by the Welsh Government through Health and Care Research Wales (Grant awarded to the National Centre for Mental Health, No. CA04; AJ, MDPB, and SCL) and by the Con-COV team funded by the Medical Research Council (Grant No. MR/V028367/1). This work was also supported by Health Data Research UK, which receives its funding from HDR UK Ltd (HDR-9006) funded by the UK Medical Research Council, Engineering and Physical Sciences Research Council, Economic and Social Research Council, Department of Health and Social Care (England), Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Health and Social Care Research and Development Division (Welsh Government), Public Health Agency (Northern Ireland), British Heart Foundation (BHF), and the Wellcome Trust. This work was supported by the ADR Wales programme of work. The ADR Wales programme of work is aligned to the priority themes as identified in the Welsh Government’s national strategy: Prosperity for All. ADR Wales brings together data science experts at Swansea University Medical School, staff from the Wales Institute of Social and Economic Research, Data, and Methods (WISERD) at Cardiff University, and specialist teams within the Welsh Government to develop new evidence which supports Prosperity for All by using the SAIL Databank at Swansea University, to link and analyze anonymized data. ADR Wales is part of the Economic and Social Research Council (part of UK Research and Innovation) funded ADR UK (Grant ES/S007393/1). This work was supported by the Wales COVID-19 Evidence Centre, funded by Health and Care Research Wales.

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