GP156 Increasing rates of self-harm among children 10–14 in ireland: a ten-year national registry study 2007–2016

Despite stabilization in suicide rates in most countries, rates of Self Harm have continued to increase in young people. Research abounds as to the risks and protective factors but there is still a huge gap in our knowledge as to what leads one person to act on suicidal ideation and another to refrain, and what causes increasing numbers to engage in repetitive non-suicidal self-(NSSI). The current study examined trends in rates and trends of self-harm among young people in Ireland aged 10–14 years over a ten-year period. Methods Data from the National Self-Harm Registry Ireland on presentations to hospital emergency departments (EDs) following self-harm in 10–14 years-old during the period 2007–2016 were included. We calculated annual self-harm rates per 100,000 by age, sex and method of self-harm. Poisson Regression models were used to examine trends in rates. Results The rate of self-harm was 72 per 100,000 (34 for males and 112 for females) an increase of 75% between 2007 and 2016 (IRR = 1.75, 95% CI = 1.15–2.10), higher in boys (82% versus 72%). Rates of attempted hanging and self-cutting more than doubled (IRR=2.43 and 2.72, respectively). Attendances to hospital with self-harm increased over the course of the day peaking at 11pm, and and unexpectedly perhaps highest on Mondays. Presentations involving self-poisoning were highest, and Paracetamol containing medication were involved in the majority of presentations (51%), 19% involved NSAIDs and 12% involved minor tranquilisers (22% for boys and 9%) for girls). 8% of presentations involved alcohol. Considering those discharged from the ED, the majority (57%) were referred to CAMHS or other psychological services, however, one-quarter (24%) were discharged home without further follow-up, and 3% left before assessment. Conclusion Over a ten-year period, rates of self-harm in all age groups (10–24) increased by 22%, but the largest increase was in youth aged under 10–14 (+82%). The increasing rates as well as increases in methods of self-harm associated with higher lethality underline the need for interventions to reduce risk of repeat self-harm and suicide among this population. Presentations to hospital provide an opportunity to provide appropriate referral and treatment options for those engaging in self-harm. Having access to child and adolescent psychiatry services in pediatric hospitals would allow appropriate consultation, but in the absence of such services, it is essential that pediatric staff are competent in providing a therapeutic assessment and aware of appropriate service to refer on to.