Title: Risk and resilience: Self-harm and suicide ideation, attempts and completion among high risk groups and the population as a whole.
Funder: Department of Health (England)

Abstract: Background With the launch of the new national suicide prevention strategy, high quality research is needed to support its implementation and evaluation of progress. Government and Research Councils have highlighted that ultilising existing data sources can be an efficient and effective use of resources. Epidemiological survey datasets are inclusive of people not in contact with services, enable subgroups to be identified and include controls for comparison. Excellent data resources exist, which have only been partially examined. Aims 1. To prioritise factors to address to reduce suicide behavior among people with a history of self-harm. Including identifying the different factors that predict people who self-harm and have a history of suicide attempts and those who self-harm and have not attempted suicide. 2. To identify the patterns, associations and characteristics of self-harm and suicide behaviour, including risk and protective factors relevant at a time of economic recession, in the population as a whole and to inform the effective and appropriate targetting of treatment for self-harm and preventing suicide in particular groups. 3. To examine the prevalence and trends in self-harm among young people. Research plan and methods of investigation This study employs mixed methods. The quantitative and participatory methods are described here under different strands, but in practice the researchers will work across both with strong cross-fertilisation. 1. Statistical analysis strand a) Adult Psychiatric Morbidity Surveys (APms) 1993, 2000, 2007, supplemented with two other key general population survey datasets: Scottish Health Survey (SHeS) 2008-2011 and Health Survey for England (HSE) 1994-2011 linked to data on cause of death. b) Seven datasets would be examined to further profile specific groups. (Ethnic Minority Psychiatric Morbidity Illness Rates in the Community (EMPIRIC) 2000; National Survey of Work-search and Wellbeing 2011; Adult Psychiatric Morbidity Among Prisoners in England and Wales; OPCS Survey of Psychiatric Morbidity among Homeless People, 1994; Mental health of children and young people (2004); Northern Ireland Young Life and Times Survey, 2008; Mental Health of Young People Looked After by Local Authorities in Great Britain, 2001-2003). The statistical analysis would involve: - Descriptive analysis of prevalence, trends and associations, in the population as a whole as in subgroups, using SPSS. - Multivariate logistic regression analysis to identify risk and protective factors when other factors are controlled for, for the population as a whole and for specific subgroups, using STATA. - Latent class analysis to identify patterns in how self-harming, and different types of suicide ideation and suicide behaviours cluster together in the population, using Latent Gold. 2. PPI participation strand to enable facilitated consultation on study outputs. Team The team of researchers from NatCen, Warwick and Bristol has a strong track record in policy relevant research and effective inclusion through consultation. Potential impact This study will generate benchmarking statistics on prevalence, trends, and associations with self-harm and suicide behaviours, based on robust general population samples. This provides a context for studies that focus on populations in contact with support, treatment and services. The application of latent class analysis will provide new ways of understanding how suicide risk behaviours cluster in the population. Because such approaches involve population segmentation, they have particular relevance for the targetting of policy and interventions. This study will also highlight, where sample size permits, the specific experiences of LGB, BME, veteran and other groups where a research gap has been identified.


Research activity codes: 3.1 PRIMARY PREVENTION INTERVENTIONS TO MODIFY BEHAVIOURS OR PROMOTE WELL-BEING;2.3 PSYCHOLOGICAL, SOCIAL AND ECONOMIC FACTORS
Health categories: MENTAL HEALTH