The term self-harm encompasses a wide variety of behaviors and motivations. Some people inflict injuries upon themselves with the intent to cause pain and wounds, but not death. This is often considered nonlethal self-injurious behavior. These can include piercing, cutting, and even drug overdose.
Other actions, which overlap with nonlethal self-injurious behaviors, can be committed with the sole intent of causing serious injury or death. Sometimes these behaviors are the cause of suicide, and sometimes they are not. Understanding how self-harm is related to suicide could decrease the risk of suicide among those who engage in self-harming acts.
In an effort to get a clearer picture on this relationship, Matthew Miller of the Department of Health Policy and Management at the Injury Control Research Center at the Harvard School of Public Health in Boston recently conducted a follow-up to a previous study on 3,600 individuals. The participants were monitored immediately following their release from a hospital for nonlethal self-injury. Miller looked at the rate of completed and attempted suicides four years later and also at the methods used in first and subsequent self-injurious behaviors.
The results revealed that individuals who were first admitted due to cutting, drug overdose, or piercing had a higher risk of committing suicide after their release, but by means other than those they first employed. Surprisingly, the majority of suicides that occurred were among people with no history of either hospitalization or prior psychiatric episodes. This suggests that even though many people take their lives on their first attempt at self-injury, many do not.
Miller said, “Our findings suggest that preventing suicide among persons with a history of self-harm must account for the possibility that they will adopt methods with higher case-fatality ratios than they previously tried.” The fact that self-harmers were admitted to the hospital for serious injuries could provide a window of opportunity for clinicians and caregivers. If individuals with a history of self-harm, especially behaviors like cutting and drug overdose, are provided with tailored mental health care, this may lessen the likelihood of further more severe attempts at suicide.
Miller, Matthew, et al. (2013). Method choice in nonfatal self-harm as a predictor of subsequent episodes of self-harm and suicide: Implications for clinical practice. American Journal of Public Health 103.6 (2013): E61-8. ProQuest. Web.
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