Abstract
Background
Evidence on the impacts of the pandemic on healthcare presentations for self-harm has accumulated rapidly. However, existing reviews do not include studies published beyond 2020.
Aims
To systematically review evidence on presentations to health services following self-harm during the COVID-19 pandemic.
Methods
A comprehensive search of databases (WHO COVID-19 database; Medline; medRxiv; Scopus; PsyRxiv; SocArXiv; bioRxiv; COVID-19 Open Research Dataset, PubMed) was conducted. Studies published from 1st Jan. 2020 to 7th Sept. 2021 were included. Study quality was assessed using a critical appraisal tool.
Results
Fifty-one studies were included. 57% (29/51) were rated as ‘low’ quality, 31% (16/51) as ‘moderate’ and 12% (6/51) as ‘high-moderate’. Most evidence (84%, 43/51) was from high-income countries. 47% (24/51) of studies reported reductions in presentation frequency, including all 6 rated as high-moderate quality, which reported reductions of 17-56%. Settings treating higher lethality self-harm were overrepresented among studies reporting increased demand. Two of the 3 higher quality studies including study observation months from 2021 reported reductions in self-harm presentations. Evidence from 2021 suggested increased numbers of presentations among adolescents, particularly girls.
Conclusions
Sustained reductions in numbers of self-harm presentations were seen into the first half of 2021, though this evidence is based on a relatively small number of higher quality studies. Evidence from low- and middle-income countries is lacking. Increased numbers of presentations among adolescents, particularly girls, into 2021 is concerning. Findings may reflect changes in thresholds for help seeking, use of alternative sources of support and variable effects of the pandemic across groups.
Evidence on the impacts of the pandemic on healthcare presentations for self-harm has accumulated rapidly. However, existing reviews do not include studies published beyond 2020.
Aims
To systematically review evidence on presentations to health services following self-harm during the COVID-19 pandemic.
Methods
A comprehensive search of databases (WHO COVID-19 database; Medline; medRxiv; Scopus; PsyRxiv; SocArXiv; bioRxiv; COVID-19 Open Research Dataset, PubMed) was conducted. Studies published from 1st Jan. 2020 to 7th Sept. 2021 were included. Study quality was assessed using a critical appraisal tool.
Results
Fifty-one studies were included. 57% (29/51) were rated as ‘low’ quality, 31% (16/51) as ‘moderate’ and 12% (6/51) as ‘high-moderate’. Most evidence (84%, 43/51) was from high-income countries. 47% (24/51) of studies reported reductions in presentation frequency, including all 6 rated as high-moderate quality, which reported reductions of 17-56%. Settings treating higher lethality self-harm were overrepresented among studies reporting increased demand. Two of the 3 higher quality studies including study observation months from 2021 reported reductions in self-harm presentations. Evidence from 2021 suggested increased numbers of presentations among adolescents, particularly girls.
Conclusions
Sustained reductions in numbers of self-harm presentations were seen into the first half of 2021, though this evidence is based on a relatively small number of higher quality studies. Evidence from low- and middle-income countries is lacking. Increased numbers of presentations among adolescents, particularly girls, into 2021 is concerning. Findings may reflect changes in thresholds for help seeking, use of alternative sources of support and variable effects of the pandemic across groups.
| Original language | English |
|---|---|
| Journal | British Journal of Psychiatry |
| DOIs | |
| Publication status | Published - 11 Jul 2022 |
