Rates of self-harm
There were 12,588 recorded presentations of deliberate self-harm in 2018, involving 9,785 individuals. Taking the population into account, the age-standardised rate of individuals presenting to hospital in the Republic of Ireland following self-harm was 210 per 100,000 population. This was a significant increase of 6% compared with the rate recorded in 2017 (199 per 100,000 population). The rate in 2018 was 12% higher than in 2007, the year before the economic recession (see Figure 1).
In 2018, the national male rate of self-harm was 193 per 100,000 population, 7% higher than in 2017. The female rate was 229 per 100,000 population, which was 5% higher than in 2017. With regard to age, the peak rate for men was in the 20–24-age group, at 543 per 100,000 population. The peak rate for women was among 15–19-year-olds, at 766 per 100,000 population.
Figure 1: Person-based rate of deliberate self-harm from 2002 to 2018 by gender
Source: National Suicide Research Foundation (2019)
‘All’ in the legend refers to the rate for both men and women per 100,000 population.
Self-harm and drug and alcohol use
Intentional drug overdose was the most common form of deliberate self-harm reported in 2018, occurring in 7,792 (61.9%) of episodes. As observed in 2017, overdose rates were higher among women (66.9%) than among men (55.8%). Minor tranquillisers and major tranquilisers were involved in 35% and 10% of drug overdose acts, respectively. In total, 34% of male and 48% of female overdose cases involved analgesic drugs, most commonly paracetamol, which was involved in 30% of all drug overdose acts. In 69% of cases, the total number of tablets taken was known, with an average of 29 tablets taken in episodes of self-harm that involved a drug overdose.
In 2018, there was an increase in the number of self-harm presentations to hospital involving street drugs by 27% (from 583 to 742). Since 2007, the rate per 100,000 of intentional drug overdose involving street drugs has increased by 54% (from 9.9 to 15.3 per 100,000 population). Cocaine and cannabis were the most common street drugs recorded by the registry in 2018, present in 5% and 3% of overdose acts, respectively. Cocaine was most common among men, involved in 15% of overdose acts by 25–34-year-olds. Cannabis was most common among men aged 5–24 years old, and was present in 8% of overdose acts. Alcohol was involved in 30% of all self-harm presentations in 2018, and was significantly more often involved in male episodes of self-harm than females (34% vs 27%, respectively).
Street drugs and self-harm
The sharp increase in the use of street drugs involved in self-harm presentations in 2018 – in particular cannabis – was discussed. A recent systematic review and meta-analysis found that cannabis consumption in adolescence was associated with increased risk of developing major depression in young adulthood, and an increased risk of suicidal ideation and suicide attempts in young adulthood.2 The report authors suggest that public health policies to address the use of illegal substances should be further developed.
1 Griffin E, McTernan N, Wrigley C, et al. (2019) National Self-Harm Registry Ireland annual report 2018. Cork: National Suicide Research Foundation. https://www.drugsandalcohol.ie/31193/
2 Gobbi G, Atkin T, Zytynski T, et al. (2019) Association of cannabis use in adolescence and risk of depression, anxiety, and suicidality in young adulthood: a systematic review and meta-analysis. JAMA Psychiatry, 76(4): 426–434.
