Self-harm among the homeless population in Ireland: a national registry-based study of incidence and associated factors

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dc.contributor.author Barrett, Peter
dc.contributor.author Griffin, Eve
dc.contributor.author Corcoran, Paul
dc.contributor.author O'Mahony, Mary T.
dc.contributor.author Arensman, Ella
dc.date.accessioned 2018-01-04T16:07:18Z
dc.date.available 2018-01-04T16:07:18Z
dc.date.issued 2017-12-27
dc.identifier.citation Barrett, P., Griffin, E., Corcoran, P., O’Mahony, M. T. and Arensman, E. 'Self-harm among the homeless population in Ireland: a national registry-based study of incidence and associated factors', Journal of Affective Disorders, 229, pp. 523-531. doi: 10.1016/j.jad.2017.12.040 en
dc.identifier.volume 229
dc.identifier.startpage 523
dc.identifier.endpage 531
dc.identifier.issn 0165-0327
dc.identifier.uri http://hdl.handle.net/10468/5234
dc.identifier.doi 10.1016/j.jad.2017.12.040
dc.description.abstract Background: Self-harm is a strong predictor of future suicide, but little is known about self-harm among the homeless population. The study aim was to estimate the incidence of self-harm among the homeless population and to assess factors associated with self-harm. Methods: Data on self-harm presentations to 34 hospital emergency departments in Ireland were collected by the National Self-Harm Registry Ireland (NSHRI). Index presentations between 2010 and 2014 were included for the homeless and fixed residence populations. Incidence rates of self-harm were calculated using NSHRI data and census estimates. Factors associated with self-harm and repeated self-harm were analysed by multivariable-adjusted logistic regression. Results: The age-standardised incidence rate of self-harm was 30 times higher among the homeless (5,572 presentations per 100,000) compared with those with a fixed residence (187 presentations per 100,000). Homeless people had significantly higher odds of being male (OR 1.86, 95%CI 1.56–2.23), presenting with self-cutting (vs. overdose, OR 2.15, 95%CI 1.74–2.66) and having psychiatric admission (vs. general admission, OR 2.43, 95%CI 1.66–3.57). Homeless people had higher odds of self-harm repetition within 12 months (vs. fixed residence, OR 1.46, 95%CI 1.21–1.77). The odds of repetition were significantly increased among homeless who engaged in self-cutting (vs. overdose, OR 1.76, 95%CI 1.17–2.65) and did not receive psychiatric review at index presentation (vs. reviewed, OR 1.54, 95%CI 1.05–2.26). Limitations: The study only reflects self-harm presenting to hospital, and assumes no change in homelessness status after index presentation. Residual confounding may affect the results. Conclusion: There is a disproportionate burden of self-harm among the homeless. Targeted preventive actions are warranted. en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher Elsevier en
dc.relation.uri https://www.sciencedirect.com/science/article/pii/S0165032717320797
dc.rights © 2017 Elsevier B.V. All rights reserved. This manuscript version is made available under the CC-BY-NC-ND 4.0 license. en
dc.rights.uri http://creativecommons.org/licenses/by-nc-nd/4.0/ en
dc.subject Self-harm en
dc.subject Homeless en
dc.subject Overdose en
dc.subject Self-cutting en
dc.subject Incidence en
dc.subject Epidemiology en
dc.title Self-harm among the homeless population in Ireland: a national registry-based study of incidence and associated factors en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother Ella Arensman, Epidemiology & Public Health, University College Cork, Cork, Ireland. +353-21-490-3000 Email: earensman@ucc.ie en
dc.internal.availability Full text available en
dc.check.info Access to this article is restricted until 12 months after publication by request of the publisher. en
dc.check.date 2018-12-27
dc.date.updated 2018-01-04T15:58:23Z
dc.description.version Accepted Version en
dc.internal.rssid 420480087
dc.description.status Peer reviewed en
dc.identifier.journaltitle Journal of Affective Disorders en
dc.internal.copyrightchecked No !!CORA!! en
dc.internal.licenseacceptance Yes en
dc.internal.IRISemailaddress earensman@ucc.ie en


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© 2017 Elsevier B.V. All rights reserved. This manuscript version is made available under the CC-BY-NC-ND 4.0 license. Except where otherwise noted, this item's license is described as © 2017 Elsevier B.V. All rights reserved. This manuscript version is made available under the CC-BY-NC-ND 4.0 license.
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