Original Research

Methods of deliberate self-harm in a tertiary hospital in South Africa

Deirdre Pieterse, Jacqueline Hoare, Kerry-Ann Louw, Elsie Breet, Michelle Henry, Ian Lewis, Jason Bantjes
South African Journal of Psychiatry | Vol 26 | a1399 | DOI: https://doi.org/10.4102/sajpsychiatry.v26i0.1399 | © 2020 Deirdre Pieterse, Jacqueline Hoare, Kerry-Ann Louw, Elsie Breet, Michelle Henry, Ian Lewis, Jason Bantjes | This work is licensed under CC Attribution 4.0
Submitted: 15 April 2019 | Published: 21 April 2020

About the author(s)

Deirdre Pieterse, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
Jacqueline Hoare, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
Kerry-Ann Louw, Department of Psychiatry, Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa
Elsie Breet, Department of Psychology, Stellenbosch University, Cape Town, South Africa
Michelle Henry, Centre for Higher Education Development, University of Cape Town, Cape Town, South Africa
Ian Lewis, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
Jason Bantjes, Department of Psychology, Stellenbosch University, Cape Town, South Africa


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Abstract

Background: Little is known about the methods of deliberate self-harm (DSH) in South Africa (SA), despite the importance of means restriction as a public health strategy to reduce the morbidity and mortality associated with self-harm.

Aim: The aim of this study was to investigate the range of methods used in DSH and identify the socio-demographic and clinical factors associated with violent and non-violent methods of DSH among patients treated at a tertiary hospital in SA.

Setting: The study was conducted at an urban, tertiary level emergency department at Groote Schuur hospital in Cape Town, South Africa.

Method: Data were collected from 238 consecutive DSH patients who presented for emergency department treatment at the hospital. Logistic regression models were used to explore the factors associated with violent and non-violent methods of DSH.

Results: Self-poisoning was the most common method of self-harm (80.3%). Prescription medication was the most common form of self-poison (57.6%), while a large number of patients used non-prescription paracetamol (40.9%). In the regression analysis, male gender, stating that the reason for DSH was to escape a situation and history of substance use were associated with violent method of DSH.

Conclusion: Improved monitoring of prescription medications commonly used in DSH is integral to public health suicide prevention strategies in SA. This study underscores the need for substance use interventions in the healthcare setting.


Keywords

deliberate self-harm; non-fatal suicide; general hospital; mental health; methods of self-harm; means restriction; suicide prevention

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