Tag Archives: self-harm

PhD fellow focus: Lukasz Cybulski

2 Feb

In this series, we meet our new PhD fellows to find out what they will be researching and what they hope to achieve.

Lukasz Cybulski started his PhD in September 2017. He has a background in research and mental health work with an interest in the synthesis of public health policy, the use of research findings in the ‘real-world’ and ways of increasing research transparency and reproducibility. The opportunity to combine these interests is what drew him to the projects at the Greater Manchester Patient Safety Translational Research Centre.

His PhD will focus on self-harm and suicide in children, adolescents and young adults. The epidemiology (the study of how diseases affect the health and illness of populations) of self-harm and suicide has not been extensively studied among registered primary care patients. The majority of people diagnosed with a mental health disorder, including conditions such as depression, anxiety disorders and eating disorders, are rarely referred to, or treated by, specialist mental health services.

Lukasz will investigate this topic using a nationally representative group of primary care patients,  linking with routinely collected clinical datasets and national mortality records. This will provide a unique platform for investigating people diagnosed with ‘mild to moderate’ mental health problems, their clinical management across healthcare sectors, and their subsequent risks of nonfatal and fatal suicidality and other causes of premature death. Epidemiological studies of this nature allow for the identification of populations at particular risk, and aid the development of clinical guidelines that maximise patient safety.

Self-harm in children and adolescents

1 Feb

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Self-harm is any act of self-poisoning or self-injury whether intentional or not. Self-harm is the strongest risk factor for possible future suicide, with suicide being the second most common cause of death before the age of 25 worldwide.

In recent years, there has been a rise in suicide rates in children and adolescents, as well as a marked increase in psychological distress. The purpose of this study was to identify how the rates of self-harm have changed, and how these changes compare in different genders, as well as among different age groups. The Clinical Practice Research Datalink (CPRD) database was used to identify 16,912 records of children or adolescents presenting to their GP after self-harming between 2001 and 2014. Researchers then looked at what proportion had been referred to mental health services and what drugs, if any, were prescribed in the 12 months following the self-harm.

The most notable trends were:

  • A 68% increase in incidence of self-harm in girls aged 13-16
  • Those who lived in socially deprived areas were 23% less likely to be referred in the 12 months following self-harm
  • Children and adolescents who self-harmed were at increased risk:
    • 9 times more likely to die of unnatural causes
    • 17 times more likely to die by suicide
    • 34 times more likely to die through alcohol or drug poisoning.

 Read more in the full paper in BMJ, or the plain English publication summary.

Development of a resource to reduce self-harm

1 Feb

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Recent work led by The University of Manchester has developed and tested a brief theory-based psychological intervention (the “volitional help sheet” or VHS) that significantly reduces suicidal ideation and behaviour among people admitted to hospital following an episode of self-harm (Armitage et al., British Journal of Psychiatry, 2016).  However, it is not yet known whether the intervention is acceptable to, and effective in, preventing suicidal ideation and behaviour among the broader population.

The goal of this research is to translate these findings into a resource that will meet the needs of people at risk of self-harm and/or suicide who may not have been admitted to hospital with self-harm.

As people at risk of self-harm and/or suicide may present at any point in any care pathway, we will be investigating multiple physical and mental health conditions in both primary and hospital care. The focus of the research will be on understanding expressions of intent to self-harm and/or suicide and in gauging patient and health care professionals’ reactions to using the VHS as a tool to promote patient safety, with a view to refining and optimising the VHS.

Introducing…Safety in Marginalised Groups: Mental Health

5 Jul

by Nav Kapur and Roger Webb

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Safety in mental health services:  reducing suicide and self-harm

Nav Kapur, Research Lead, says:

‘It’s fantastic to be involved in the new NIHR Patient Safety Translational Research Centre.  It is particularly exciting that safety in mental health services will be a prominent part of the new work.  We are really looking forward to getting started.  We will be making new appointments (both Research Associates and funded PhD students) in order to make this a world-beating research programme.  The focus on both suicide and self-harm is really pertinent given the current policy and health priority on these very important outcomes.  So over the summer and autumn we will get going on the actual research using a variety of methods.  Personally I can’t wait to start working with the internationally-leading team of researchers, academics and clinicians across the PSTRC’.

Roger Webb, key project lead, says:

‘I’m enthused by this wonderful new initiative, which enables our Centre for Mental Health and Safety to join forces in working collaboratively with a much larger group of internationally renowned experts in the patient safety field. Our planned work programme, focussing on self-harm and suicide, encompasses a number of ground-breaking studies.

These studies include:

  • evaluating how changes to health service provision may impact on national suicide  rates
  • developing and testing psychological treatments following self-harm
  • investigating key transitions from institutional care to living back in the community, among discharged patients and released prisoners with enduring mental health problems
  • assessing clinical management of common mental health problems across healthcare sectors, and subsequent risks of self-harm, suicide and other causes of premature death.’