View in EDS

Variation in the clinical management of self-harm by area-level socio-economic deprivation: findings from the multicenter study of self-harm in England.

Saved in:
Bibliographic Details
Title: Variation in the clinical management of self-harm by area-level socio-economic deprivation: findings from the multicenter study of self-harm in England.
Authors: Geulayov, G., Casey, D., Bale, L., Brand, F., Clements, C., Kapur, N., Ness, J., Waters, K., White, S., Hawton, K.
Source: Psychological Medicine. Apr2024, Vol. 54 Issue 5, p1004-1015. 12p.
Subjects: Research funding, Socioeconomic factors, Hospital care, Hospitals, Self-mutilation, Odds ratio, Research, Confidence intervals, Patient aftercare, Medical referrals
Geographic Terms: England
Abstract: Background: We investigated disparities in the clinical management of self-harm following hospital presentation with self-harm according to level of socio-economic deprivation (SED) in England. Methods: 108 092 presentations to hospitals (by 57 306 individuals) after self-harm in the Multicenter Study of Self-harm spanning 17 years. Area-level SED was based on the English Index of Multiple Deprivation. Information about indicators of clinical care was obtained from each hospital's self-harm monitoring systems. We assessed the associations of SED with indicators of care using mixed effect models. Results: Controlling for confounders, psychosocial assessment and admission to a general medical ward were less likely for presentations by patients living in more deprived areas relative to presentations by patients from the least deprived areas. Referral for outpatient mental health care was less likely for presentations by patients from the two most deprived localities (most deprived: adjusted odd ratio [aOR] 0.77, 95% CI 0.71–0.83, p < 0.0001; 2nd most deprived: aOR 0.80, 95% CI 0.74–0.87, p < 0.0001). Referral to substance use services and 'other' services increased with increased SED. Overall, referral for aftercare was less likely following presentations by patients living in the two most deprived areas (most deprived: aOR 0.85, 95% CI 0.78–0.92, p < 0.0001; 2nd most deprived: aOR 0.86, 95% CI 0.79–0.94, p = 0.001). Conclusions: SED is associated with differential care for patients who self-harm in England. Inequalities in care may exacerbate the risk of adverse outcomes in this disadvantaged population. Further work is needed to understand the reasons for these differences and ways of providing more equitable care. [ABSTRACT FROM AUTHOR]
Copyright of Psychological Medicine is the property of Cambridge University Press and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
FullText Text:
  Availability: 0
Header DbId: pbh
DbLabel: Psychology and Behavioral Sciences Collection
An: 176758373
AccessLevel: 6
PubType: Academic Journal
PubTypeId: academicJournal
PreciseRelevancyScore: 0
IllustrationInfo
Items – Name: Title
  Label: Title
  Group: Ti
  Data: Variation in the clinical management of self-harm by area-level socio-economic deprivation: findings from the multicenter study of self-harm in England.
– Name: Author
  Label: Authors
  Group: Au
  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Geulayov%2C+G%2E%22&quot;&gt;Geulayov, G.&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Casey%2C+D%2E%22&quot;&gt;Casey, D.&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Bale%2C+L%2E%22&quot;&gt;Bale, L.&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Brand%2C+F%2E%22&quot;&gt;Brand, F.&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Clements%2C+C%2E%22&quot;&gt;Clements, C.&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Kapur%2C+N%2E%22&quot;&gt;Kapur, N.&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Ness%2C+J%2E%22&quot;&gt;Ness, J.&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Waters%2C+K%2E%22&quot;&gt;Waters, K.&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22White%2C+S%2E%22&quot;&gt;White, S.&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Hawton%2C+K%2E%22&quot;&gt;Hawton, K.&lt;/searchLink&gt;
– Name: TitleSource
  Label: Source
  Group: Src
  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22Psychological+Medicine%22&quot;&gt;Psychological Medicine&lt;/searchLink&gt;. Apr2024, Vol. 54 Issue 5, p1004-1015. 12p.
– Name: Subject
  Label: Subjects
  Group: Su
  Data: &lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Research+funding%22&quot;&gt;Research funding&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Socioeconomic+factors%22&quot;&gt;Socioeconomic factors&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Hospital+care%22&quot;&gt;Hospital care&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Hospitals%22&quot;&gt;Hospitals&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Self-mutilation%22&quot;&gt;Self-mutilation&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Odds+ratio%22&quot;&gt;Odds ratio&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Research%22&quot;&gt;Research&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Confidence+intervals%22&quot;&gt;Confidence intervals&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Patient+aftercare%22&quot;&gt;Patient aftercare&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Medical+referrals%22&quot;&gt;Medical referrals&lt;/searchLink&gt;
– Name: SubjectGeographic
  Label: Geographic Terms
  Group: Su
  Data: &lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22England%22&quot;&gt;England&lt;/searchLink&gt;
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background: We investigated disparities in the clinical management of self-harm following hospital presentation with self-harm according to level of socio-economic deprivation (SED) in England. Methods: 108 092 presentations to hospitals (by 57 306 individuals) after self-harm in the Multicenter Study of Self-harm spanning 17 years. Area-level SED was based on the English Index of Multiple Deprivation. Information about indicators of clinical care was obtained from each hospital&#39;s self-harm monitoring systems. We assessed the associations of SED with indicators of care using mixed effect models. Results: Controlling for confounders, psychosocial assessment and admission to a general medical ward were less likely for presentations by patients living in more deprived areas relative to presentations by patients from the least deprived areas. Referral for outpatient mental health care was less likely for presentations by patients from the two most deprived localities (most deprived: adjusted odd ratio [aOR] 0.77, 95% CI 0.71–0.83, p &lt; 0.0001; 2nd most deprived: aOR 0.80, 95% CI 0.74–0.87, p &lt; 0.0001). Referral to substance use services and &#39;other&#39; services increased with increased SED. Overall, referral for aftercare was less likely following presentations by patients living in the two most deprived areas (most deprived: aOR 0.85, 95% CI 0.78–0.92, p &lt; 0.0001; 2nd most deprived: aOR 0.86, 95% CI 0.79–0.94, p = 0.001). Conclusions: SED is associated with differential care for patients who self-harm in England. Inequalities in care may exacerbate the risk of adverse outcomes in this disadvantaged population. Further work is needed to understand the reasons for these differences and ways of providing more equitable care. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: &lt;i&gt;Copyright of Psychological Medicine is the property of Cambridge University Press and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=176758373
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1017/S0033291723002799
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 12
        StartPage: 1004
    Subjects:
      – SubjectFull: Research funding
        Type: general
      – SubjectFull: Socioeconomic factors
        Type: general
      – SubjectFull: Hospital care
        Type: general
      – SubjectFull: Hospitals
        Type: general
      – SubjectFull: Self-mutilation
        Type: general
      – SubjectFull: Odds ratio
        Type: general
      – SubjectFull: Research
        Type: general
      – SubjectFull: Confidence intervals
        Type: general
      – SubjectFull: Patient aftercare
        Type: general
      – SubjectFull: Medical referrals
        Type: general
      – SubjectFull: England
        Type: general
    Titles:
      – TitleFull: Variation in the clinical management of self-harm by area-level socio-economic deprivation: findings from the multicenter study of self-harm in England.
        Type: main
  BibRelationships:
    HasContributorRelationships:
      – PersonEntity:
          Name:
            NameFull: Geulayov, G.
      – PersonEntity:
          Name:
            NameFull: Casey, D.
      – PersonEntity:
          Name:
            NameFull: Bale, L.
      – PersonEntity:
          Name:
            NameFull: Brand, F.
      – PersonEntity:
          Name:
            NameFull: Clements, C.
      – PersonEntity:
          Name:
            NameFull: Kapur, N.
      – PersonEntity:
          Name:
            NameFull: Ness, J.
      – PersonEntity:
          Name:
            NameFull: Waters, K.
      – PersonEntity:
          Name:
            NameFull: White, S.
      – PersonEntity:
          Name:
            NameFull: Hawton, K.
    IsPartOfRelationships:
      – BibEntity:
          Dates:
            – D: 01
              M: 04
              Text: Apr2024
              Type: published
              Y: 2024
          Identifiers:
            – Type: issn-print
              Value: 00332917
          Numbering:
            – Type: volume
              Value: 54
            – Type: issue
              Value: 5
          Titles:
            – TitleFull: Psychological Medicine
              Type: main
ResultId 1